Intravitreal injections during the COVID-۱۹ pandemic era

Abstract Background: This study aimed to evaluate the clinical characteristics and changes in the number of patients receiving intravitreal injections (IVIs) at a tertiary hospital during the coronavirus disease ۲۰۱۹ (COVID-۱۹) pandemic as compared to the pre-pandemic period. Methods: This retrospective, cross-sectional study included ۳,۲۱۱ patients with retinal disease, who received IVIs of anti-vascular endothelial growth factor (anti-VEGF) between January and May ۲۰۲۰. This ۵-month period was divided into a pre-pandemic and a pandemic period. Clinical and demographic data were collected and were compared between the patients in each period. All COVID-۱۹ infection precautions were implemented to minimize the potential transmission of COVID-۱۹ to both healthcare workers and patients. Results: A total of ۳,۲۱۱ IVIs were administered to patients with diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, and other retinal conditions. Diabetic retinopathy was the most common indication for treatment in the pre-pandemic as well as pandemic periods. Bevacizumab (Avastin, Roche) was the most common IVI type, followed by aflibercept (Eylea, Bayer). Of ۳,۲۱۱ IVIs, ۲,۹۴۳ (۹۱.۷%) were administered during the pre-pandemic period and ۲۶۸ (۸.۳%) during the pandemic period. There was a statistically significant decrease in injections between the pre-pandemic and pandemic periods, with an overall reduction of ۹۰.۸% in IVIs (P < ۰.۰۵). No cases of confirmed transmission of COVID-۱۹ orcomplications associated with IVIs were recorded. Conclusions: This study showed that the number of IVIs and patient visits decreased significantly, by more than ۱۰-fold, during the lockdown period. These findings show that COVID-۱۹ has turned the management of sight-threatening eye diseases into a challenging process and must be addressed if future healthcarerestrictions are imposed. Keywords: COVID-۱۹ retina intravitreal injection age-related macular degeneration diabetic retinopathy retinal vein occlusion anti-vascular endothelial growth factor anti-VEGF bevacizumab aflibercept