Assessing the impact of COVID-19 on visual acuity for diabetic macular edema patients treated with aflibercept in the UK

Purpose : Assessing the impact of COVID-19 on visual acuity (VA) in eyes treated for Diabetic Macular Edema. Methods : Anonymized data from 21 UK centers were extracted from Medisoft for eyes receiving treatment with aflibercept and with VA data in the pre-COVID baseline period (01/10/19 to 30/03/20, N=3,248). Comparisons for period 1 (01/04/20 to 30/09/20, N=2,077) – lockdown following RCOphth Medical Retinal Management Plan, period 2 (01/10/20 to 30/03/21, N=1,850) - intermittent lockdown and period 3 (01/04/21 to 30/09/21, N=1,111; 20 centers) - easing of COVID-19 restrictions. VA change was compared for baseline VA, <7 vs. ≥7 injections before period 1 and for eyes losing ≥5 ETDRS letters in period 1. Results : The mean change in VA for eyes with a baseline VA of ≤35 letters, was +4.9, +2.5 and +1.7 letters from baseline to period 1, period 1 to 2 and period 2 to 3, respectively. For baseline VA of 36-55 letters, +0.6, +1.7 and -0.2 letters, from baseline to period 1, period 1 to 2 and period 2 to 3, respectively. For baseline VA of 56-75 letters, +1.9, zero and -0.5 letters, from baseline to period 1, period 1 to 2 and period 2 to 3, respectively. For baseline VA of >75 letters, -4.3, -0.5 and zero letters, from baseline to period 1, period 1 to 2 and period 2 to 3, respectively. For eyes receiving <7 injections before period 1, the mean change in VA was -1.9 letters (N=1,335) from baseline to period 1, +0.5 letters (N=992) from period 1 to 2 and +0.1 letters (N=592) from period 2 to 3. For ≥7 injections before period 1, the mean change in VA was -3.4 letters (N=742) from baseline to period 1, -0.4 letters (N=515) from period 1 to 2 and -1.1 letters (N=303) from period 2 to 3. For eyes losing ≥5 letters before period 1, the mean change in VA when receiving ≥1 injection in period 2 was +3.9 letters (N=283) from period 1 to 2 and -0.1 letters (N=140) from period 2 to 3. For eyes not retreated in period 2, the mean change in VA was -2.9 letters (N=162) from period 1 to 2 and zero letters (N=73) from period 2 to 3. Conclusions : Visual gain between time periods was more likely for lower baseline vision. For eyes with <7 or ≥7 injections before period 1, the mean VA change was a loss in vision in the first period with little change in later periods. For eyes with ≥5 letter loss in period 1, subsequent visual gain was more likely if treatment continued.

Citation

Scanlon, P. H., Norridge, C. F. E., Mukherjee, R., Lotery, A. J., Peto, T., Chhabra, R., Bailey, C., Eleftheriadis, H., Ghanchi, F., & Jones, C. (2022). Assessing the impact of COVID-19 on visual acuity for diabetic macular edema patients treated with aflibercept in the UK. Investigative Ophthalmology & Visual Science, 63(7), 3776 – F0197. https://iovs.arvojournals.org/article.aspx?articleid=2781424

URI

https://hdl.handle.net/20.500.14709/709