Intravitreal injections during COVID-19 outbreak: Real-world experience from an Italian tertiary referral center

Carnevali, Adriano; Giannaccare, Giuseppe; Gatti, Valentina; Scuteri, Gianfranco; Randazzo, Giorgio; Scorcia, Vincenzo

doi:10.1177/1120672120962032

Cited by 32 publications

(49 citation statements)

References 14 publications

(21 reference statements)

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“… 12 Recent studies show that the 2020 pandemic closure resulted in a 53–75% reduction in IVIs when compared to 2019. 4 , 13 , 14 Our study demonstrates a relatively lower, but significant, 10% overall decrease in IVI volume in 2020 after the severest of restrictions were rescinded compared to the same period in 2019, with over 2.5 times as many delayed intravitreal injection treatment encounters. At least 42% of these delayed IVIs were directly related to pandemic-related constraints.…”

Section: Discussionmentioning

confidence: 60%

Short-Term Effects of COVID-19-Related Deferral of Intravitreal Injection Visits

Ashkenazy¹,

Goduni²,

Smiddy³

2021

OPTH

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Purpose To determine secondary effects of the mandated COVID-19 pandemic closure period for elective treatment on non-elective, injection-based retina care and outcomes. Patients and Methods In this cross-sectional, retrospective analysis of a single-provider outpatient clinic across multiple satellites, consecutive patients returning for intravitreal injections (IVIs) of anti-vascular endothelial growth factor or corticosteroids were identified as “delayed” or “undelayed” during a six-week study interval during the COVID-19 pandemic that closely following a mandated period of prohibited elective encounters. A “delayed” encounter was defined as having a follow-up interval exceeding 33% of the recommended cycle. Patients seen for IVIs during the corresponding six-week interval a year previously were identified for study as pre-COVID-19 controls. Main outcome measures included best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) assessment based on findings of intraretinal or subretinal fluid consistent with new or recurrent neovascular events. Results The study included 183 eyes of 144 patients who underwent IVI-based care from June 18, 2020, through August 7, 2020, compared to 193 eyes of 154 patients injected during the corresponding interval 1 year before. There were 62 eyes of 46 patients seen in the study period later than scheduled (among 144 patients of 183 eyes in total), which represented a larger proportion of delayed patients compared to the previous year (31.9% vs. 14.9%, p<0.0005). Considering the patterns from the control group, the attributed delay due to COVID-19 was 15.0% of patients. The delayed return eyes had a greater decline in BCVA (3 letters), higher rates of worsened OCT results (48%), and prompted reduction in previously prescribed injection intervals (p<0.02). Conclusion The unintended consequence of delayed care of patients on established care regimens should be anticipated, and mitigate strategies considered if similar restrictions are mandated in the future.

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Section: Discussionmentioning

confidence: 60%

Short-Term Effects of COVID-19-Related Deferral of Intravitreal Injection Visits

Ashkenazy¹,

Goduni²,

Smiddy³

2021

OPTH

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“…During the time-frame for group B, the prevalence of sero-positive cases in the CAM was 11.3%, among the highest in Spain, of which 30% were asymptomatic [24]. On the other hand, no naso-pharyngeal PCRs were performed, although their usefulness in detecting asymptomatic patients among those scheduled for IVI treatment or procedures viewed as low risk of transmission, is poor (< 1%) [28,29]. Likewise, our results do not include an analysis of the possible infection and transmission among the healthcare staff involved in the procedure, who, in our facility, were equipped from the outset with the recommended preventive measures for conducting the procedure and did not combine with the staff providing care to COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in the Intravitreal Injection (IVI) Procedure at a Spanish Urban Tertiary Hospital

Fernández

García

Sánchez

et al. 2021

Preprint

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Purpose: To describe the rate of COVID-19 in intravitreal injection (IVI) procedure at the onset of the pandemic.Methods: This transversal, observational and retrospective study included patients treated with IVI, in 3 groups. A: from February 20 to March 15, 2020, a period prior to lockdown and the first preventive measures against viral transmission. B: from March 16 to May 3, after the start of both, and C: from May 4 to June 19, after lockdown. Age, sex, diagnosis, drug, IVI laterality, visual acuity, percentage of single eyes, date of COVID-19 diagnosis, incidence among the Hospital attended population and number of COVID-19 patients admitted daily, were collected.Results: 1049 patients were treated, 564 (53.7%) on two or more occasions. COVID-19 rate was 1.51% (8/529) in group A, 0.21% (1/469) in B and 0% in C (0/926) (p=0.0001). The highest incidence peak x105 inhabitants and the mean daily admission rate, for the periods corresponding to the three groups, were 93.70/7.70 (SD 7.32), 418.72/27.83 (SD 24.68) and 24.58/2.28 (SD 1.97), respectively.Conclusion: The favourable trend in the COVID-19 rate among our patients, after implementing preventive measures against viral transmission, may assist in adequately planning IVI procedure in the future.

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“…Several international studies prioritized patients for intravitreal injections and split patients into three priorities 3,11,15 . Below is a summarization of these lists:…”

Section: Intravitreal Injectionsmentioning

confidence: 99%

Retina in the Age of COVID-19

Gelnick

Akanda

Lieberman

2021

Advances in Ophthalmology and Optometry

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Intravitreal injections during COVID-19 outbreak: Real-world experience from an Italian tertiary referral center

Cited by 32 publications

References 14 publications

Short-Term Effects of COVID-19-Related Deferral of Intravitreal Injection Visits

Short-Term Effects of COVID-19-Related Deferral of Intravitreal Injection Visits

COVID-19 in the Intravitreal Injection (IVI) Procedure at a Spanish Urban Tertiary Hospital

Retina in the Age of COVID-19

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