Problems in diabetic retinopathy treatment and management during the
COVID-19 pandemic
Abstract
Purpose: The aim of this study is to determine the problems occurring
during the COVID-19 pandemic period in patients treated with
intravitreal (IV) injection for diabetic retinopathy, and to provide
recommendations for treatment management in these patients. Methods:
Twenty-nine eyes of 17 patients were included in this prospective,
observational study. The frequency of hospital visits, treatments
performed, and detailed ophthalmological examination findings, including
optical coherence tomography findings and glycated haemoglobin (HbA1c)
values, were recorded in the period before the COVID-19 pandemic. During
the COVID-19 pandemic period, the detailed ophthalmological examination
findings and HbA1c values were noted after the patients who had delayed
their routine control time (>90 days) applied to the
hospital. New treatments were planned according to the current
situation. Results: Seventeen patients who were diagnosed with diabetic
macular edema were included in the study; 10 were female (58.8%) and
seven were male (41.2%). The mean time interval between following
visits was 45.52±5.85 days during the pre-pandemic period, but it
increased to 110.41±13.47 days during the COVID-19 pandemic period
(p<.001). Visual acuity (LogMAR) was 0.44±0.36 in the
pre-pandemic period and 0.76±0.48 during the COVID-19 pandemic period
(p=.003). Central macular thickness was 300.10±85.56 µm in the
pre-pandemic period and it increased to 387.10±144.48 µm during the
COVID-19 pandemic period (p=.007). In three patients, complications of
diabetic retinopathy that could not be cured by medical treatment
developed and surgical treatment was recommended. Conclusions: Delays in
the treatment of diabetic retinopathy may cause permanent impairment in
visual functions. The COVID-19 pandemic has caused an increase in the
hospital visit intervals of patients, and this situation has resulted in
disruptions in the follow-up and treatment of patients with diabetic
retinopathy. Alternative diagnosis and treatment practices are needed in
order to manage these and similar processes smoothly.