Much of retina care involves administration of in-person, time-sensitive interventions. Clinicians have grappled with how to continue administering this essential care in the face of the COVID-19 pandemic. In search of a deeper understanding of patient perspectives that will inform strategies to optimize adherence with vision-preserving therapies, a study recently determined that concern regarding COVID-19 exposure during eye clinic visits and diabetic retinopathy (DR) treatment specifically (vs. exudative age-related macular degeneration [AMD]) were associated with loss to follow-up.

The study consisted of a non-validated telephone survey of 348 patients at high risk of both reversible and irreversible vision loss from lapses in care, including those receiving regular intravitreal injections for either exudative AMD or vision-threatening complications of DR. A retrospective medical record review was conducted in parallel with the survey.

The researchers found that although 208 (60%) of the respondents believed COVID-19 exposure at the eye clinic was unlikely or extremely unlikely, 49 (14%) believed it was likely or extremely likely. A subset of patients felt they were likely or extremely likely to be exposed during clinic visits for intravitreal injections. The study noted 78 participants (22%) were lost to follow-up.

Survey results suggested that fear of exposure was associated with a roughly fourfold increase in the odds of patient loss to follow-up. “During uncertain times, we should proactively address unwarranted patient fears,” the researchers concluded. “In particular, we should communicate that the very low risk of a COVID-19 transmission event should be balanced with the risk of vision loss from treatment delays in a variety of ophthalmic pathologies.”

Lindeke-Myers A, Zhao PYC, Meyer BI, et al. Patient perceptions of SARS-CoV-2 exposure risk and association with continuity of ophthalmic care. JAMA Ophthalmol. March 11, 2021. [Epub ahead of print].