Effects of the COVID-19 pandemic on neovascular age-related macular degeneration and response to delayed Anti-VEGF treatment

OBJECTIVES: To investigate the effects of the COVID-19 pandemic on the treatment course of neovascular age-related macular degeneration (nAMD) patients who received anti-VEGF injection therapy with real-life data. METHODS: This retrospective study consisted of 116 eyes of 106 patients. Ophthalmic examination, assessment of best-corrected visual acuity (BCVA), optical coherence tomography (OCT) findings and data of last two visits before restrictions (V-2 and V-1) and the first visit (V0) after the release of national lockdown and subsequent visits (V1 and Vlast) were recorded. The lockdown period was determined by the time interval between March 11 and June 1, 2020. MAIN RESULTS: The injection interval before V-1 was significantly longer than the interval after V0 (2.56 ± 0.9 vs. 2.14 ± 0.8 months, P = 0.02). While the median central macular thickness (CMT) was significantly increased at V0 compared to V-1 [274(132–711) vs. 238(136–628), P < 0.001], the median CMT was significantly lower at V1 compared to V0 [256 (136–591) vs. 274(132–711), P = 0.003]. The median BCVA was 0.67(0.1–1.1) logMAR at V-1 and significantly worsened to 0.78 (0.1–1.2) logMAR at V0 (P = 0.003). Although the median BCVA improved to 0.69 logMAR (0.1–1.2) at Vlast, the difference did not reach statistical significance compared to V0 (P = 0.08). CONCLUSION: Treatment delay due to the COVID-19 pandemic cause progression of nAMD and visual impairment. To plan more frequent anti-VEGF treatments and visits may be an appropriate approach until the disease stabilizes. However, it should be kept in mind that despite the improvement in OCT findings, the desired success in VA could not be achieved in the short term.