The purpose of this study was to examine the effects of delays experienced with scheduled IVI treatments in patients who were treated in our clinic using the T&E protocol, using data collected during the COVID-19 pandemic as a test case. found that missing scheduled IVI treatments can cause reduced treatment efficacy and poorer visual outcome in patients with DME. reported a low risk of substantial vision loss (i.e., ≥ 2 lines) when in patients treated using anti-VEGF IVI therapy, regardless of the persistence of edema on the other hand, Weiss et al. Similarly, inadequately treating central retinal vein occlusion (CRVO) can adversely affect visual outcome. ![]() In addition, an increase (or new onset) of retinal fluid is more likely to cause vision loss compared to either a lack of fluid or persistent fluid. Previous studies suggest that inadequately treating nvAMD can result in poor visual outcome moreover, intraretinal fluid (IRF) can have a worse effect on vision compared to subretinal fluid (SRF). Recent reports regarding compliance with anti-VEGF treatment schedules have documented a decrease of up to 50% in the number of planned IVI treatments during the pandemic compared to the corresponding pre-pandemic period The COVID-19 pandemic has severely disrupted standard patient care worldwide, leading to deviations and/or delays in the planned treatment schedule in many patients, due primarily to difficulties related to treatment access and/or patient fears of contracting the SARS-CoV-2 virus. Nevertheless, limited data is available regarding the consequences of deviating from the recommended treatment schedule. ![]() ![]() The T&E approach has been shown to achieve similar visual and anatomical outcomes compared to PRN ( pro re nata) and monthly treatment regimens for nvAMD and DME. Additionaly, a treat-and-extend (T&E) regimen in which the treatment interval is progressively extended is often used to resolve the retinal and/or subretinal exudates often associated with these conditions and prevent their recurrence. Neovascular age-related macular degeneration (nvAMD), diabetic macular edema (DME), and macular edema associated with retinal vein occlusion (RVO) are often treated long-term with intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) in order to prevent progressive vision loss.
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