The Impact Of The New Coronavirus Outbreak On Anti-VEGF Therapy

Objective: Explore the impact of the new coronavirus(COVID-19)epidemic on intravitreal injection of anti-vascular endothelial growth factor(anti-vascular endothelial growth factor,anti-VEGF)drugs.Methods: This study is a retrospective study.The subjects of the study were all patients who received intravitreal injection of anti-VEGF drugs at the Ophthalmology Department of the First Affiliated Hospital of China Medical University from January 27,2020(the date of suspension due to the outbreak of the epidemic)to June 1,2020.All patients underwent visual acuity,intraocular pressure,fundus examination,optical coherence tomography(OCT)examination to measure the central retinal thickness(CRT)of the macula,and the clinical characteristics and treatment results of anti-VEGF treatment patients in the same period in 2019 Make comparisons and analyze the impact of the epidemic on the effectiveness of anti-VEGF treatment.Results: During the study period,a total of 93 anti-VEGF treatments were given.Compared with a total of 307 anti-VEGF treatments during the same period in 2019,the number of intravitreal injections of anti-VEGF drugs during the new coronavirus epidemic has dropped by 70%.After excluding 13 patients with proliferative diabetic retinopathy who were treated with anti-VEGF therapy as a surgical adjuvant,13 eyes were included,59 patients and 72 eyes were included,including 29 patients with wet age-related macular degeneration(neovascular age-related macular degeneration,n AMD)35 eyes,20 eyes of 20 patients with retinal vein occlusion(RVO),15 eyes of 15 patients with central retinal vein occlusion(CRVO),branch retinal vein occlusion(BRVO)There were 5 patients with 5 eyes and 10 patients with diabetic macular edema(DME)with 17 eyes.The overall age is 29-89 years old,with an average age of62.4±12.0 years old.There are 32 males and 27 females.Among them,59 eyes of 46 patients had completed 3+PRN anti-VEGF drug treatment before the epidemic.All of them experienced treatment interruption due to the impact of the epidemic,and affected vision and anatomical healing.The number of eyes whose treatment was discontinued for more than 4.5 months was 59 eyes,a significant increase compared to 32 eyes in the same period in 2019(p<0.001).The average best-corrected visual acuity(best-corrected visual acuity,BCVA)at the last follow-up during the epidemic)Is 0.86±0.41,which is significantly lower than 0.53±0.36 in the same period in 2019(p<0.001).The number of postoperative complications in patients who discontinued treatment increased.The average BCVA at the follow-up visit was 0.98±0.41,which was significantly lower than the average BCVA 0.59±0.22 at the last follow-up before the outbreak began(p<0.001).The logarithm of minimal angle of resolution(Log MAR)BCVA average decrease was correlated with the increase in duration of treatment interruption(Pearson correlation analysis,r=0.386,p=0.003).In the stepwise multiple regression analysis,it can also be confirmed that longer treatment interruption is associated with worse vision(p=0.003).Conclusion: The new crown epidemic has a far-reaching impact on anti-VEGF treatment.During the epidemic,timely formulation of treatment guidelines and reasonable allocation of treatment resources will help reduce its negative impact.