COVID-19 Pandemic Lockdowns’ Impact on Visual Acuity of Diabetic Macular Edema: A Large Cohort

Abstract

Introduction: Evaluating the impact of unplanned treatment gap, secondary to COVID-19 pandemic lockdowns, on visual acuity in previously treated diabetic macular edema (DME) patients. Methods: A multi-center, retrospective, study of DME patients, previously treated with anti-VEGF injections who were followed-up during COVID-19 pandemic (2020) comparing to pre COVID-19 period (2019) Results: A total of 634 DME patients with a mean age of 68.4 years met the inclusion criteria, 385 were assessed in 2019 (pre COVID-19) and 239 patients assessed in 2020 (COVID-19). Baseline BCVA among patients in 2019 and 2020 was 0.52±0.44, 0.45±0.43 (LogMAR, respectively). There was no significant difference between the years 2020 and 2019 in baseline BCVA (p=0.07). Mean number of anti-VEGF injections was significantly lower (5 Vs 6, p<0.01), with a major lower ratio of injections per patient in the COVID-19 first lockdown period (March-June 2020) in the COVID-19 group. Baseline BCVA (p<0.01) was the only significant predictor of final BCVA. Number of injections, age, gender and the year weren’t found as a predictor of final BCVA. Conclusions: In a large cohort of DME patients, an unplanned delay in treatment with anti- VEGF injections for 2-3 months due to COVID-19 pandemic lockdown, had no significance impact on visual acuity. For most patients, returning to routine treatment regimen was sufficient for BCVA maintaining.

Case report: A case of Acute Macular Neuroretinopathy secondary to Influenza A virus during Long COVID

“…In fact, similar to Gomel et al. ( 71 ), we strongly believe that the possible mechanisms for the ME of the patient may include systemic immune storm such as hyperpyrexia and an increasing index of inflammation. In our case, the patient who had a history of SARS-CoV-2 infection accompanied by long-term fatigue and memory loss.…”

“…This occurs when the human body is in a state of ischemia or inflammation, and can induce impaired blood-retinal barrier, increased vascular permeability, dysfunctional angiogenesis, accumulation of subretinal fluid, and formation of retinal edema. In fact, similar to Gomel et al (71), we strongly believe that the possible mechanisms for the ME of the patient may include systemic immune storm such as hyperpyrexia and an increasing index of inflammation. In our case, the patient who had a history of SARS-CoV-2 infection accompanied by long-term fatigue and memory loss.…”