Delayed anti-VEGF injections during the COVID-19 pandemic and changes in visual acuity in patients with three common retinal diseases: A systematic review and meta-analysis

Im, James; Jin, Ya-Ping; Chow, Ronald; Dharia, Riddhi Shah; Yan, Peng

doi:10.1016/j.survophthal.2022.08.002

Cited by 10 publications

(7 citation statements)

References 46 publications

(86 reference statements)

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“…Of 175 international systematic reviews identified in PubMed (date of search: 9 December 2022), 10 potentially relevant reviews described impact on glycaemic control,17–20 diabetic ketoacidosis21 and interventions to recover or sustain diabetes or hypertension care 22–26. Overall, improvements in glycaemic control were seen in high-income countries during the pandemic, likely reflecting a high motivation for diabetes self-management due to associations with COVID-19 outcomes, supportive care through teleconsultations, and easier meal-planning, improved sleep habits and reduced access to fast food when staying at home during movement restrictions 17 18.…”

Section: Introductionmentioning

confidence: 99%

“…Four systematic reviews reported on interventions to sustain diabetes or hypertension care during the COVID-19 pandemic internationally,22 23 25 26 and one review protocol was identified 24. Telehealth and home visits were mentioned as modalities to manage diabetic foot conditions 25.…”

Section: Introductionmentioning

confidence: 99%

“…Telehealth and home visits were mentioned as modalities to manage diabetic foot conditions 25. Therapies enabling longer durations between consecutive treatments and better triaging of high-risk patients were mentioned as strategies to mitigate healthcare disruptions in a study on diabetes-related retinal deterioration 23. Two reviews indicated self-monitoring of blood pressure as a suitable alternative approach to support hypertension management 22 26.…”

Section: Introductionmentioning

confidence: 99%

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Disruption of diabetes and hypertension care during the COVID-19 pandemic and recovery approaches in the Latin America and Caribbean region: a scoping review protocol

Jabakhanji,

Ogungbe,

Angell

et al. 2024

BMJ Open

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IntroductionThe COVID-19 pandemic significantly disrupted primary healthcare globally, with particular impacts on diabetes and hypertension care. This review will examine the impact of pandemic disruptions of diabetes and hypertension care services and the evidence for interventions to mitigate or reverse pandemic disruptions in the Latin America and Caribbean (LAC) region.Methods and analysesThis scoping review will examine care delivery disruption and approaches for recovery of primary healthcare in the LAC region during the COVID-19 pandemic, focusing on diabetes and hypertension awareness, detection, treatment and control. Guided by Arksey and O’Malley’s scoping review methodology framework, this protocol adheres to the Joanna Briggs Institute guidelines for scoping review protocols and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance for protocol development and scoping reviews. We searched MEDLINE, CINAHL, Global Health, Embase, Cochrane, Scopus, Web of Science and LILACS for peer-reviewed literature published from 2020 to 12 December 2022 in English, Spanish or Portuguese. Studies will be considered eligible if reporting data on pandemic disruptions to primary care services within LAC, or interventions implemented to mitigate or reverse pandemic disruptions globally. Studies on COVID-19 or acute care will be excluded. Two reviewers will independently screen each title/abstract for eligibility, screen full texts of titles/abstracts deemed relevant and extract data from eligible full-text publications. Conflicts will be resolved through discussion and with the help of a third reviewer. Appropriate analytical techniques will be employed to synthesise the data, for example, frequency counts and descriptive statistics. Quality will be assessed using the Newcastle Ottawa Quality Assessment Scale.Ethics and disseminationNo ethics approval was needed as this is a scoping review of published literature. Results will be disseminated in a report to the World Bank and the Pan American Health Organization, in peer-reviewed scientific journals, and at national and international conferences.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Disruption of diabetes and hypertension care during the COVID-19 pandemic and recovery approaches in the Latin America and Caribbean region: a scoping review protocol

Jabakhanji,

Ogungbe,

Angell

et al. 2024

BMJ Open

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“…4 During the years 2020 to 2022, the COVID-19 pandemic and the associated lockdowns led to a significantly decreased number in patient visits around the world, both as a direct result of stay-at-home orders, but also because of fear of contracting the virus. 5,6 Furthermore, the COVID-19 lockdown led to reduced access to eye care when ophthalmology clinics and hospitals had to limit or suspend nonemergency services to prevent spreading of the virus. 7 This led to postponed or canceled appointments, delayed treatments, and reduced access to eye care for individuals with nonurgent conditions.…”

mentioning

confidence: 99%

“…There have been several previous publications on patient outcomes worldwide during the pandemic. 4,6,8,[11][12][13][14] However, this is the first report from a setting without a lockdown, thereby providing valuable insights into the effects of the pandemic on ophthalmologic health care under these unique circumstances.…”

mentioning

confidence: 99%

Retinal vein occlusions before and during the COVID-19 pandemic. Visual outcomes and treatment patterns in a country with no mandatory lockdown.

Farrell,

Epstein

2024

Retina

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Purpose: To investigate the incidence, treatment patterns and visual outcomes in patients with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) before and during the COVID-19 pandemic in a country with no mandatory lockdown. Methods: This retrospective study included 788 patients presenting with a retinal vein occlusion (RVO) during 2019–2022 at St. Erik Eye Hospital. The control group and study groups consisted of patients presenting before and during the pandemic respectively. Results: The incidence of diagnosed RVO cases decreased from 281 patients before the pandemic to 236 patients during the first year of the pandemic (p<0.05). In BRVO patients at the end of follow-up, the best-corrected visual acuity (BCVA) improved 10.3 letters (95% CI 7.6-12.9) in the control group compared to 14.3 letters (95% CI 12.6-16.0) in the study groups (p<0.05). In CRVO patients the BCVA improved 6.3 letters (95% CI 2.7-10.0) in the control group compared to 8.6 letters (95% CI 5.7-11.4) in the study groups (p=NS). Overall, the number of intravitreal anti-vascular endothelial growth factor (VEGF) injections increased from 7.0 (95% CI 6.6-7.3) in the control group to 7.6 (95% CI 7.4-7.8) in the study groups (p<0.05). Conclusion: Good visual and anatomical outcomes were sustained, and the number of intravitreal anti-VEGF injections increased significantly in RVO patients during the COVID-19 pandemic.

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Economic Assessment in Resource-Constrained Systems: Individual-Level Simulation Model in Wet Age-Related Macular Degeneration and Diabetic Macular Oedema

Li,

Berdunov,

Hamilton

et al. 2024

Ophthalmol Ther

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Introduction Cost-effectiveness analyses typically ignore healthcare system resource constraints. Ophthalmology is affected by resource constraints because of increasing disease prevalence and the use of resource-intensive treatments. This study evaluated the impact of resource constraints on the cost-effectiveness of faricimab 6 mg, compared with aflibercept 2 mg and ranibizumab biosimilar 0.5 mg, for treating wet age-related macular degeneration (wAMD) or diabetic macular oedema (DMO) over a 5-year horizon. Methods A microsimulation model estimated the impact of resource constraints on patients visits, delays, costs and quality-adjusted life-year (QALY) losses due to treatment delays at a typical UK National Health Service eye hospital treating 1500 patients with wAMD and 500 patients with DMO. Patient characteristics, treatment regimens and treatment intervals were informed using published literature and expert opinion. Resource constraint was represented by limiting the number of available intravitreal injection appointments per week, with growing demand caused by rising disease prevalence. The model compared outcomes across three scenarios; each scenario involved treating all patients with one of the three treatments. Results Over 5 years, in a resource-constrained hospital, compared with aflibercept, faricimab use resulted in the avoidance of 12,596 delays, saved GBP/£15,108,609 in cost and avoided the loss of 60.06 QALYs. Compared with ranibizumab biosimilar, faricimab use resulted in the avoidance of 18,910 delays, incurred £2,069,088 extra cost and avoided the loss of 105.70 QALYs, resulting in an incremental cost-effectiveness ratio of £19,574/QALY. Conclusions Accounting for resource constraints in health economic evaluation is crucial. Emerging therapies that are more durable and require less frequent clinic visits can reduce treatment delays, leading to improved QALY outcomes and reduced burden on healthcare systems. Faricimab reduced the number of delayed injections, leading to improved QALY outcomes for patients in a healthcare system with resource constraints. Faricimab is cost-saving when compared with aflibercept and cost-effective when compared with ranibizumab biosimilar. Graphical Abstract

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Delayed anti-VEGF injections during the COVID-19 pandemic and changes in visual acuity in patients with three common retinal diseases: A systematic review and meta-analysis

Cited by 10 publications

References 46 publications

Disruption of diabetes and hypertension care during the COVID-19 pandemic and recovery approaches in the Latin America and Caribbean region: a scoping review protocol

Disruption of diabetes and hypertension care during the COVID-19 pandemic and recovery approaches in the Latin America and Caribbean region: a scoping review protocol

Retinal vein occlusions before and during the COVID-19 pandemic. Visual outcomes and treatment patterns in a country with no mandatory lockdown.

Economic Assessment in Resource-Constrained Systems: Individual-Level Simulation Model in Wet Age-Related Macular Degeneration and Diabetic Macular Oedema

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