Short-term outcomes of patients with macular edema due to retinal vein oclussion: the effect of COVID -19 pandemic

Author: Elena Casas Maroto (Spain)

Co-authors: Raquel Belillas Nuñez, Inés Del Barrio Manso, Maria Dolores Martín Sanchez

Purpose

To describe the management and the impact of delayed care of retinal vein oclussions (RVO) during the coronavirus disease 2019 (COVID-19) pandemic at a single center in Spain

Setting/Venue

Retina Department. Hospital Universitario infanta Cristina. Spain

Methods

Follow-up study of 50 patients with macular edema secondary to RVO treated with intravitreal (IVT) injection, monitored from the start of Spanish COVID 19 lockdown (March 13, 2020) and 6 months later. Best corrected visual acuity (BCVA) and time between consultation or treatment were analysed.

Results

13 patients with CRVO and 37 patients with BRVO were being treated with ITV injection (68% anti-VEGF injection and 32% dexamethasone implants) at the time the national lockdown was established. After the review of their clinical history, we established a priority protocol and managed patients in an individualized manner. 5 patients were excluded from the follow-up due to COVID-19 related death or change of city. 54% of patients were consulted again with a complete ophthalmological exploration in less tan 3 months and/or were treated with a modified Treat & Extent (T&E) regimen or reinjection of dexamethasone implant as needed. A pandemic – related delay in treatment and follow up ocurred in 36% of patients, with fear of contagion being the main cause of it. Among this group of patients, we diagnosed 1 case of neovascular glaucoma and 1 case of retinal neovascularization. In terms of BCVA, only 26% of patients showed lower BCVA tan before COVID-19 quarentine, while 36% experiment an improvement in BCVA.

Conlusions

The COVID-19 crisis has been a challenge for the clinical management of ophthalmologic pathologies , especially those needing ITV treatment such as RVO. During the pandemic, every hospital around the world put effort to define priority protocols and to adjust the management of patients in order to preserve their vision and avoid complications related to interruption of treatment. From our experience, adequate follow –up and treatment was successfully achieved in most cases.

Financial Disclosure

None