The lockdown last spring caused patients to delay seeking routine medical care. Looking at the effects of this on vision, new research in Ophthalmology found that about 40% of people who were scheduled to see a retina specialist for intravitreal injections during this time either cancelled or were no-shows. They noted that the delay in care of about five weeks caused vision loss in many of these individuals.
The chart review included patients aged 18 or older with DME and/or PDR, wet AMD or RVO who were scheduled to see a retinal specialist during the mandated lockdown starting in mid-March 2020. These individuals had received an intravitreal injection in the 12 weeks prior.
Of the 1,041 patients in the study, 620 (60%) went to their scheduled visit, while 376 (36%) cancelled and 45 (4%) were no-shows. For patients who did not attend their scheduled visit, the average delay in care was about five weeks and their VA was assessed at the subsequent visit.
Patients who cancelled a visit were older, and no-shows had lower baseline vision based on EDTRS letters (no-shows: 53.27, cancelled visits: 60.79, completed visits: 62.81). No-shows were also more likely to have DME and/or PDR [no-shows: 13 (29%), cancelled visits: 56 (16%), completed visits: 81 (13%)].
Of note: patients who missed a visit had more visual loss compared with those who kept their appointment [no-shows: -5.024 (±1.88), cancelled visits: -1.633 (±0.65), completed visits: 0.373 (±0.50)].
Vision loss was more acute in patients with DME and/or PDR (-3.48 letters vs. -2.71 letters) and RVO (-3.22 letters vs. -0.95 letters). Wet AMD patients who missed their appointment also sustained more visual loss than individuals with the same condition who kept their visit as scheduled (-1.23 letters vs. -0.24 letters).
Further studies are necessary to determine whether these vision changes will persist over a longer period, the study authors concluded in their paper.
Song W, Singh RP, Rachitskaya AV, et al. The effect of delay in care among patients requiring intravitreal injections. Ophthalmology. December 31, 2020. [Epub ahead of print].