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?:abstract
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OBJECTIVE/PURPOSE To examine the effect of delay in care on visual acuity in patients requiring intravitreal injections. DESIGN Retrospective cohort study. SUBJECTS Patients aged 18 or older with DME and/or PDR, nAMD, or RVO scheduled to be seen by a retina specialist during the mandated lock down period from March 14 - May 4, 2020 (COVID-19 period) and who had received an intravitreal injection in the 12 weeks prior. METHODS Chart review was performed and demographics, ophthalmic diagnoses, procedures performed, and visual acuity at all visits were recorded. MAIN OUTCOME MEASURES Visual acuity in patients who completed, canceled, and no-showed for the COVID-19 period visit. RESULTS Of the 1,041 total patients in this study, 620 (60%) completed the scheduled visit, while 376 (36%) canceled and 45 (4%) were no-shows. In patients who missed the scheduled visit, the average delay in care was 5.34 weeks. In those who missed a visit, the visual acuity was assessed at the subsequent visit. Patients who canceled a visit were older, and patients who no-showed had lower baseline vision [mean EDTRS letters (±SE); no-show: 53.27 (±3.21), canceled: 60.79 (±1.11), completed: 62.81 (±0.84), p=0.0101] and were more likely to have DME and/or PDR [no-show: 13 (29%), canceled: 56 (16%), completed: 81 (13%), p=0.0456]. Patients who missed a visit lost more vision as compared to the patients who completed the scheduled visit [no-show: -5.024 (±1.88), canceled: -1.633 (±0.65), completed: 0.373 (±0.50), p=0.0028]. In particular, patients with DME and/or PDR [- 3.48 (±1.95) vs 2.71 (±1.75) letters, p=0.0203] and RVO [-3.22 (±1.41) vs 0.95 (±1.23) letters, p=0.0230], and to lesser degree with nAMD [-1.23 (±0.70) vs -0.24 (±0.56) letters, p=0.2679], lost vision compared to patients with same diagnoses who completed the scheduled visit. CONCLUSIONS In patients requiring intravitreal injections, a delay in care of 5.34 weeks resulted in vision loss. It was seen in all patients but was more prominent in DME and/or PDR and RVO patients. Further studies are necessary to examine whether these vision changes persist over a longer duration of time.
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