International impact of the COVID-19 pandemic lockdown on intravitreal therapy outcomes: Fight Retinal Blindness registry

Purpose: To evaluate the impact of the COVID-19 pandemic lockdowns on the outcomes of eyes treated for neovascular AMD (nAMD), diabetic macular edema (DME) and retinal vein occlusion (RVO) in eight countries.

Methods: Multicenter international database study of 5782 eyes (4708 patients) receiving intravitreal anti-VEGF injections prior, during and after national lockdowns. Baseline visit was defined as the last visit within 3 months prior to lockdown, and pre- and post-lockdown periods were defined as 6 months before and after the lockdown date.

Results: Eyes with nAMD (n=4649) lost vision in all countries in proportion to the reduced number of injections. Mean VA change post-lockdown ranged from -0.4 to -3.8 logMAR letters and the median number of injections/visits decreased from 4-5/4-7 to 2-4/2-4 post-lockdown. DME (n=654) and RVO (n=479) eyes mean VA change ranged from -2.8 to +1.7 letters and -1.6 to +0.1 letters, and the median number of injections/visits decreased from 2.5-5/4-6 to 1-3/2-4 and from 3-5.5/4-5 to 1-3.5/2-3.5, respectively. The 6-month dropout rates post-lockdown were 20% for nAMD, 27% for DME and 28% for RVO.

Conclusions: This international study provides estimates of the impact of COVID-19 pandemic lockdown on intravitreal therapy and suggests that prioritizing nAMD eyes appears appropriate.