@article{Hurand2023-gc,

title = {IMPACT study: Impact of adherence to anti-VEGF intravitreal 

 injections for macular disease during COVID 19-related 

 confinement in France},

author = {Victoire Hurand and Jean-Baptiste Ducloyer and Florian Baudin and Serge Aho and Michel Weber and Laurent Kodjikian and François Devin and Pierre-Henry Gabrielle and Catherine Creuzot-Garcher and Pascale Massin and CFSR Research Net},

year  = {2023},

date = {2023-02-01},

journal = {Acta Ophthalmol.},

volume = {101},

number = {1},

pages = {91–99},

publisher = {Wiley},

abstract = {PURPOSE: The aim of this study was to evaluate the impact of 

 adherence to French coronavirus disease 2019 (COVID 19)-related 

 guidelines for intravitreal injection (IVI) practice on the 

 visual outcomes of patients treated with anti-vascular 

 endothelial growth factor (VEGF) agents for macular diseases 

 during the first lockdown period. METHODS: Observational 

 multicentre study including all patients from 18 centres with an 

 IVI initially planned during the lockdown. Visual acuity (VA, 

 ETDRS) was recorded at 1 and 4 months after lockdown. French 

 COVID 19-related guidelines recommended maintaining IVI 

 practice. We defined three groups of patients: A, adherent to 

 guidelines; NA+, non-adherent with delayed IVIs; and NA-, 

 non-adherent without IVIs performed during the lockdown. Risk 

 factors for non-adherence and visual loss were studied. RESULTS: 

 A total of 3020 eyes of 3020 patients, aged 77.8 $±$ 11.6 

 years, 59.8% women, were included. 59.3% were 

 non-adherent(46.7% NA+, 12.6% NA-). A smaller decrease in VA 

 at 4 months was observed in the A group than the NA+ and NA- 

 group (-0.2 $±$ 6.7, -0.3 $±$ 6.9 and -1.5 $±$ 6.9, 

 respectively [p < 0.001]). Factors associated with non-adherence 

 were in multivariable analysis, older age, hospital practice, 

 low-density population areas, high viral incidence areas, longer 

 intervals between injection and treat and extent protocol. 

 Factors associated with visual loss at 4 months in multivariable 

 analysis were, being in the NA- group, older age, T&E and fixed 

 regimens. CONCLUSION: Strict adherence to guidelines was 

 associated with better visual outcome, although most of our 

 patients did not attend as planned. Identification of patients 

 at risk could help in the future in case of a new pandemic 

 lockdown.},

keywords = {COVID-19; intravitreal injection; nAMD; visual acuity},

pubstate = {published},

tppubtype = {article}

}