Research Article
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COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri

Year 2023, Volume: 7 Issue: 2, 122 - 127, 31.08.2023
https://doi.org/10.25048/tudod.1252096

Abstract

Amaç: COVID-19 pandemisi nedeniyle tedaviye verilen aranın diyabetik maküla ödemi (DMÖ) olgularındaki anatomik ve fonksiyonel
etkilerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: COVID-19 nedeniyle anti-vasküler büyüme faktörü (VEGF) tedavisine ara verilen DMÖ olguları çalışmaya dahil
edildi. Olguların yaş, cinsiyet, tedaviye verilen ara süresi ve tekrar tedavi sonrası enjeksiyon sayısı ile takip süresi kaydedildi. Karantina
öncesi son vizitleri (V0), karantina sonrası ilk (V1) ve son vizitlerindeki (V2) görme keskinlikleri (GK) ve optik koherans tomografi
ile 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 verilen
ara 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 GK
sırasıyla 0,64, 0,64 ve 0,63 LogMAR (p=0,168), ortalama SMK değerleri sırasıyla 383,06, 434,82 ve 373,27 mikron (p<0,001) bulunmuştur.
Grup 1’de V0, V1 ve V2 vizitlerindeki ortalama GK sırasıyla 0,53, 0,50 ve 0,52 LogMAR (p=0,263); ortalama SMK değerleri sırasıyla
358,72, 386,59 ve 389,70 mikron (p=0,056) olarak bulunmuştur. Grup 2’de V0, V1 ve V2 vizitlerindeki ortalama GK sırasıyla 0,78, 0,83
ve 0,74 LogMAR (p=0,176); ortalama SMK değerleri sırasıyla 409,09, 486,42 ve 355,70 (p<0,001) olarak bulunmuştur.
Sonuç: DMÖ olgularında Anti-VEGF tedavisinde gecikme süresi arttıkça SMK’de kötüleşme izlenirken, kısa dönemde tekrar tedaviye
başlanmasıyla GK’de bir kötüleşme olmadan SMK değerlerinde düzelme elde edilmiştir. Bu sonuç, olgulara daha önce uygulanan anti-
VEGF tedavinin kısa dönemli tedavi gecikmelerinde koruyucu olduğunu düşündürmektedir.

Supporting Institution

Bulunmamaktadır.

Project Number

Yok

Thanks

İstatistik analiz yardımı için Dr. Esra Gültekin' e teşekkür ederiz.

References

  • 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.

Effects of COVID-19 Lockdown on Diabetic Macular Edema Treatment

Year 2023, Volume: 7 Issue: 2, 122 - 127, 31.08.2023
https://doi.org/10.25048/tudod.1252096

Abstract

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 lockdown
were included in the study. Age, gender, interval time of the treatment delay, number of injections after retreatment and follow-up period
were recorded. Visual acuity (VA) and central macular thickness (CMT) of the participants at the last visit before the lockdown (V0), the
first (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 the
pandemic period was 21.03 (12-48) weeks. The average follow-up period after the initiation of retreatment was 31.2 (8-52) weeks, and
an 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<0.001), respectively. The mean VA of V0, V1 and V2 visits were 0.53, 0.50 and 0.52 LogMAR (p=0.263) in Group
1 and, 0.78, 0.83 and 0.74 LogMAR (p=0.176) in Group 2, respectively. The mean CMT values of V0, V1 and V2 visits were found as
358.72, 386.59 and 389.70 microns (p=0.056) in Group 1 and, 409.09, 486.42 and 355.70 (p<0.001) in Group 2, respectively.
Conclusion: In DME cases, as the delay time in anti-VEGF treatment increased, worsening was observed in CMT, while CMT values
improved without any worsening in VA after re-starting treatment in the short term. This result suggests that the anti-VEGF treatment
for DME has a protective effect in short-term treatment delays.

Project Number

Yok

References

  • 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.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Article
Authors

Serdar Bilici 0000-0003-1346-0850

Neriman Selçuk 0000-0003-3175-0149

Tuba Gültekin-erol 0000-0001-8712-9170

Suat Hayri Uğurbaş 0000-0002-8992-8838

Project Number Yok
Publication Date August 31, 2023
Acceptance Date July 24, 2023
Published in Issue Year 2023 Volume: 7 Issue: 2

Cite

APA Bilici, S., Selçuk, N., Gültekin-erol, T., Uğurbaş, S. H. (2023). COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri. Türkiye Diyabet Ve Obezite Dergisi, 7(2), 122-127. https://doi.org/10.25048/tudod.1252096
AMA Bilici S, Selçuk N, Gültekin-erol T, Uğurbaş SH. COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri. Turk J Diab Obes. August 2023;7(2):122-127. doi:10.25048/tudod.1252096
Chicago Bilici, Serdar, Neriman Selçuk, Tuba Gültekin-erol, and Suat Hayri Uğurbaş. “COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri”. Türkiye Diyabet Ve Obezite Dergisi 7, no. 2 (August 2023): 122-27. https://doi.org/10.25048/tudod.1252096.
EndNote Bilici S, Selçuk N, Gültekin-erol T, Uğurbaş SH (August 1, 2023) COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri. Türkiye Diyabet ve Obezite Dergisi 7 2 122–127.
IEEE S. Bilici, N. Selçuk, T. Gültekin-erol, and S. H. Uğurbaş, “COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri”, Turk J Diab Obes, vol. 7, no. 2, pp. 122–127, 2023, doi: 10.25048/tudod.1252096.
ISNAD Bilici, Serdar et al. “COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri”. Türkiye Diyabet ve Obezite Dergisi 7/2 (August 2023), 122-127. https://doi.org/10.25048/tudod.1252096.
JAMA Bilici S, Selçuk N, Gültekin-erol T, Uğurbaş SH. COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri. Turk J Diab Obes. 2023;7:122–127.
MLA Bilici, Serdar et al. “COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri”. Türkiye Diyabet Ve Obezite Dergisi, vol. 7, no. 2, 2023, pp. 122-7, doi:10.25048/tudod.1252096.
Vancouver Bilici S, Selçuk N, Gültekin-erol T, Uğurbaş SH. COVID-19 Karantina Sürecinin Diyabetik Makula Ödemi Tedavisine Etkileri. Turk J Diab Obes. 2023;7(2):122-7.

Turkish Journal of Diabetes and Obesity (Turk J Diab Obes) is a scientific publication of Zonguldak Bulent Ecevit University Obesity and Diabetes Research and Application Center.

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This journal is published annually three times (in April, August and December).

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