Effects of COVID-19 on Intravitreal Injection Clinic After Lockdown

Abstract

To examine the return of patients to intravitreal injection clinic after the COVID-19 lockdown. Patients and Methods: The electronic medical records of all patients who received intravitreal injections at a tertiary care Veterans Health Administration (VHA) clinic 14 weeks post-lockdown (5/9/20-8/13/20) in Los Angeles County were reviewed. Reference groups included injection patients during the 7-week COVID-19 lockdown (3/19/20-5/8/20) and a 7-week pre-pandemic period in 2019 (3/19/19-5/8/19). Clinic volume was compared using a one-way ANOVA. Demographic data, medical and psychiatric comorbidities, injection diagnoses, visual acuities, and clinic volumes were compared between the 3 periods using a generalized estimating equation multivariate analysis. Results: The post-lockdown period group averaged 25.1 visits per week, compared with 12.3/week during lockdown and 25.4/week pre-COVID in intravitreal injection clinic. In the post-lockdown period, the VHA injection clinic returned closer to the pre-lockdown volume compared to the VHA comprehensive clinic (98.9% vs 57.4%, p < 0.001). Post-lockdown, COPD patients and organ transplant patients were less likely to receive injections compared to 2019 (OR 0.76 p = 0.008, OR 1.37 p < 0.0001, respectively). Patients with a diagnosis of cancer increased in proportion between the pre-pandemic and the post-lockdown periods (OR 1.31, p = 0.007). No differences were found, according to psychiatric co-morbidities. After lockdown, the proportion of patients receiving injections for diabetic macular edema (DME) increased (OR 1.11, p = 0.01). Conclusion:Injection volume returned to pre-pandemic levels immediately after lockdown ended. However, patients with high-risk comorbidities did not return to intravitreal injection clinic post-lockdown. These results can inform medical organizations, which groups may need increased safety measures and targeted outreach to address their ophthalmic needs.

Impact of the COVID-19 Pandemic on the Metabolic Control of Diabetic Patients in Diabetic Retinopathy and Its Screening

“…Moreover, there have been publications on the levels of reduction in the number of intravitreal injections in the treatment of patients with DME due to the pandemic [ 13 ], which lead to vision loss in some patients who have not recovered their sight [ 14 , 15 , 16 ]. Furthermore, there have been numerous articles published on the importance of telemedicine in the treatment of patients with DM.…”

Impact of the COVID-19 on the Control of Diabetic Patients in Diabetic Retinopathy and its Screening

“…Also, there are publications, however, on the reduction due to the pandemic in the number of intravitreal injections in the treatment of patients with DME [13], which lead to vision loss in some patients who have not recovered their sight [14][15][16]. Furthermore, there have been numerous articles published on the importance of telemedicine in the control of patients with DM.…”