turk j diab obes

Turkish Journal of Diabetes and Obesity

2587-0335 2587-0572

Zonguldak Bulent Ecevit University

10.25048/tudod.1252096

Health Care Administration

Sağlık Kurumları Yönetimi

Effects of COVID-19 Lockdown on Diabetic Macular Edema Treatment

COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri

https://orcid.org/0000-0003-1346-0850

Bilici

Serdar

ZONGULDAK BÜLENT ECEVİT ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0003-3175-0149

Selçuk

Neriman

ZONGULDAK BÜLENT ECEVİT ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0001-8712-9170

Gültekin-erol

Tuba

ZONGULDAK BÜLENT ECEVİT ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0002-8992-8838

Uğurbaş

Suat Hayri

ZONGULDAK BÜLENT ECEVİT ÜNİVERSİTESİ, TIP FAKÜLTESİ

08 31 2023

7 2 122 127 02 17 2023 07 24 2023

2017

Turkish Journal of Diabetes and Obesity

Aim: Evaluating the anatomical and functional effects of delay in diabetic macular edema treatment due to the COVID-19 lockdown.Material and Methods: DME cases of which anti-vascular growth factor (VEGF) treatment was interrupted due to COVID-19 lockdownwere included in the study. Age, gender, interval time of the treatment delay, number of injections after retreatment and follow-up periodwere recorded. Visual acuity (VA) and central macular thickness (CMT) of the participants at the last visit before the lockdown (V0), thefirst (V1) and the last (V2) visit after the lockdown were evaluated. The cases were divided into subgroups based on delay in treatment:18 weeks or less (Group-1) and over 18 weeks (Group-2).Results: 89 eyes of 89 patients with average age of 63.1 (42-80) were included in the study. The average delay in the treatment during thepandemic period was 21.03 (12-48) weeks. The average follow-up period after the initiation of retreatment was 31.2 (8-52) weeks, andan average of 2.98 (1-8) anti-VEGF treatments were carried out during this period. The mean VA of V0, V1 and V2 visits of the whole group were determined as 0.64, 0.64, and 0.63 LogMAR (p=0.168), respectively, the mean CMT values were found as 383.06, 434.82,and 373.27 microns (p

Amaç: COVID-19 pandemisi nedeniyle tedaviye verilen aranın diyabetik maküla ödemi (DMÖ) olgularındaki anatomik ve fonksiyoneletkilerinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: COVID-19 nedeniyle anti-vasküler büyüme faktörü (VEGF) tedavisine ara verilen DMÖ olguları çalışmaya dahiledildi. Olguların yaş, cinsiyet, tedaviye verilen ara süresi ve tekrar tedavi sonrası enjeksiyon sayısı ile takip süresi kaydedildi. Karantinaöncesi son vizitleri (V0), karantina sonrası ilk (V1) ve son vizitlerindeki (V2) görme keskinlikleri (GK) ve optik koherans tomografiile santral makula kalınlığı (SMK) değerlendirildi. Olgular tedaviye verilen ara süresine göre 18 hafta ve altı (Grup-1) ile 18 hafta üzeri(Grup-2) olarak alt gruplara ayrıldı ve analiz edildi.Bulgular: Çalışmaya yaş ortalaması 63,1 yıl (42-80 yıl arası) olan 89 olgunun 89 gözü dahil edildi. Pandemi sürecinde tedaviye verilenara ortalaması 21,03 hafta (12-48 hafta) olarak saptandı. Tekrar tedaviye başlanan olguların ortalama takip süresi 31,2 hafta (8 - 52 hafta)olup bu süreç içerisinde ortalama 2,98 (1-8) anti-VEGF tedavi uygulanmıştı. Tüm grupta V0, V1 ve V2 vizitlerindeki ortalama GKsırasıyla 0,64, 0,64 ve 0,63 LogMAR (p=0,168), ortalama SMK değerleri sırasıyla 383,06, 434,82 ve 373,27 mikron (p

Anti-vaskuler büyüme faktörü COVID-19 Diyabetik makula ödemi Optik koherens tomografi

Anti-vascular growth factor COVID-19 Diabetic macular edema Optical coherence tomography

Bulunmamaktadır.

Yok

1. Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev. 2013;93:137-188.

2. Antonetti DA, Klein R, Gardner TW. Diabetic retinopathy. N Engl J Med. 2012;366:1227-1239.

3. Bahrami B, Hong T, Schlub TE, Chang AA. Aflibercept for persistent diabetic macular edema: forty-eight-week outcomes. Retina (Phila). 2019;39:61-68.

4. Mitchell P, Bandello F, Schmidt-Erfurth U, Lang GE, Massin P, Schlingemann RO, Sutter F, Simader C, Burian G, Gerstner O, Weichselberger A; RESTORE study group. The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology. 2011;118:615-625.

5. Nguyen QD, Shah SM, Khwaja AA, Channa R, Hatef E, Do DV, Boyer D, Heier JS, Abraham P, Thach AB, Lit ES, Foster BS, Kruger E, Dugel P, Chang T, Das A, Ciulla TA, Pollack JS, Lim JI, Eliott D, Campochiaro PA; READ-2 Study Group. Twoyear outcomes of the ranibizumab for edema of the macula in diabetes (READ-2) study. Ophthalmology. 2010;117:2146- 2151.

6. Abdelmotaal H, Ibrahim W, Sharaf M, Abdelazeem K. Causes and clinical impact of loss to follow-up in patients with proliferative diabetic retinopathy. J Ophthalmol. 2020;2020:7691724.

7. Bresnick G, Cuadros JA, Khan M, Fleischmann S, Wolff G, Limon A, Chang J, Jiang L, Cuadros P, Pedersen ER. Adherence to ophthalmology referral, treatment and followup after diabetic retinopathy screening in the primary care setting. BMJ Open Diabetes Res Care. 2020;8: e001154.

8. Comune C, Laezza MP, Giunta P, D’Andrea L, Cennamo G. Management of anti-VEGF intravitreal treatment at University Hospital Federico II of Naples during COVID-19 pandemic lockdown. Ther Adv Ophthalmol 2020;12:2515841420966861.

9. Saleh OA, Jammal H, Alqudah N, Alqudah A, Abu-Yaghi N. Clinical experience in the administration of intravitreal injection therapy at a tertiary university hospital in Jordan during the COVID-19 lockdown. Clin Ophthalmol. 2020;14:2473-2480.

10. Chatziralli I, Ventura CV, Touhami S, Reynolds R, Nassisi M, Weinberg T, Pakzad-Vaezi K, Anaya D, Mustapha M, Plant A, Yuan M, Loewenstein A; International Retina Collaborative. Transforming ophthalmic education into virtual learning during COVID-19 pandemic: a global perspective. Eye (Lond). 2021;35:1459-1466.

11. Borrelli E, Grosso D, Vella G, Sacconi R, Battista M, Querques L, Zucchiatti I, Prascina F, Bandello F, Querques G. Shortterm outcomes of patients with neovascular exudative AMD: the effect of COVID-19 pandemic. Graefes Arch Clin Exp Ophthalmol. 2020;258:2621-2628.

12. Dell’Omo R, Filippelli M, Semeraro F, Avitabile T, Giansanti F, Parmeggiani F, Romano MR, Strianese D, Romano V, Virgili G, Costagliola C. Effects of the first month of lockdown for COVID-19 in Italy: A preliminary analysis on the eyecare system from six centers. Eur J Ophthalmol. 2021 Sep;31(5):2252-2258.

13. Yang KB, Feng H, Zhang H. Effects of the COVID-19 pandemic on anti-vascular endothelial growth factor treatment in China. Front Med (Lausanne) 2020;7:576275.

14. Wecker T, Ehlken C, Bühler A, Lange C, Agostini H, Böhringer D, Stahl A. Five-year visual acuity outcomes and injection patterns in patients with pro-re-nata treatments for AMD, DME, RVO and myopic CNV. British Journal of Ophthalmology, 2017;101:353-359.

15. Finger RP, Daien V, Eldem BM, Talks JS, Korobelnik JF, Mitchell P, Sakamoto T, Wong TY, Pantiri K, Carrasco J. Antivascular endothelial growth factor in neovascular age-related macular degeneration -a systematic review of the impact of anti-VEGF on patient outcomes and healthcare systems. BMC Ophthalmol. 2020;20:294.

16. Korobelnik JF, Loewenstein A, Eldem B, Joussen AM, Koh A, Lambrou GN, Lanzetta P, Li X, Lövestam-Adrian M, Navarro R, Okada AA, Pearce I, Rodríguez FJ, Wong DT, Wu L. Guidance for anti-VEGF intravitreal injections during the COVID-19 pandemic. Graefes Arch Clin Exp Ophthalmol. 2020;258:1149-1156 .

17. Yalamanchili SP, Maatouk CM, Enwere DU, Conti TF, Hom GL, Briskin IN, Greenlee TE, Babiuch AS, Singh RP. The Short-term Effect of a Single Lapse in Anti-Vascular Endothelial Growth Factor Treatment for Diabetic Macular Edema Within Routine Clinical Practice. Am J Ophthalmol. 2020;219:215-221.

18. Weiss M, Sim DA, Herold T, Schumann RG, Liegl R, Kern C, Kreutzer T, Schiefelbein J, Rottmann M, Priglinger S, KortUEm KU. Compliance and adherence of patients with diabetic macular edema to intravitreal anti-vascular endothelial growth factor therapy in daily practice. Retina 2018;38:2293:2300.

19. Fung THM, Kuet ML, Patel MK, Puri P. Addressing COVID-19 fear to improve clinic attendance for patients with wet age-related macular degeneration. Acta Ophthalmol. 2021;99(2):e285.

20. Pellegrini M, Roda M, Lupardi E, Di Geronimo N, Giannaccare G, Schiavi C. The impact of COVID-19 pandemic on ophthalmological emergency department visits. Acta Ophthalmol. 2020;98(8):1058-1059.

21. Shields CN, Cherkas EG, Mokhashi N, Cai LZ, Pandit RR, Patel SN, Hsu J, Kuriyan AE, Klufas MA, Ho AC. Barriers to Follow-Up Retinal Care During the COVID-19 Pandemic: A Survey Study. Ophthalmic Surg Lasers Imaging Retina. 2021;52(10):526-533.

22. Lindeke-Myers A, Zhao PYC, Meyer BI, Liu EA, Levine DA, Bennett OM, Ji S, Newman-Casey PA, Rao RC, Jain N. Patient Perceptions of SARS-CoV-2 Exposure Risk and Association with Continuity of Ophthalmic Care. JAMA Ophthalmol. 2021;139(5):508-515.

23. Song, W, Singh RP, Rachitskaya AV. The Effect of Delay in Care among Patients Requiring Intravitreal Injections. Ophthalmology Retina. 2021;5(10):975-980.