Intravitreal injections during the COVID-19 pandemic era

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 2019 (COVID-19) pandemic as compared to the pre-pandemic period. Methods: This retrospective, cross-sectional study included 3,211 patients with retinal disease, who received IVIs of anti-vascular endothelial growth factor (anti-VEGF) between January and May 2020. This 5-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-19 infection precautions were implemented to minimize the potential transmission of COVID-19 to both healthcare workers and patients. Results: A total of 3,211 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 3,211 IVIs, 2,943 (91.7%) were administered during the pre-pandemic period and 268 (8.3%) during the pandemic period. There was a statistically significant decrease in injections between the pre-pandemic and pandemic periods, with an overall reduction of 90.8% in IVIs (P < 0.05). No cases of confirmed transmission of COVID-19 orcomplications associated with IVIs were recorded. Conclusions: This study showed that the number of IVIs and patient visits decreased significantly, by more than 10-fold, during the lockdown period. These findings show that COVID-19 has turned the management of sight-threatening eye diseases into a challenging process and must be addressed if future healthcarerestrictions are imposed