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Delayed Intravitreal Anti-VEGF Therapy for Patients During the COVID-19 Lockdown: An Ethical Endeavor

Clinical ophthalmology (Auckland, N.Z.), 2021-01, Vol.15, p.661-669 [Peer Reviewed Journal]

2021 Elfalah et al. ;COPYRIGHT 2021 Dove Medical Press Limited ;2021. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2021 Elfalah et al. 2021 Elfalah et al. ;ISSN: 1177-5467 ;ISSN: 1177-5483 ;EISSN: 1177-5483 ;DOI: 10.2147/OPTH.S289068 ;PMID: 33628009

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Title:
Delayed Intravitreal Anti-VEGF Therapy for Patients During the COVID-19 Lockdown: An Ethical Endeavor
Author: Elfalah, Mutasem ; AlRyalat, Saif Aldeen ; Toro, Mario Damiano ; Rejdak, Robert ; Zweifel, Sandrine ; Nazzal, Rashed ; Abu-Ameerh, Mohammed ; Ababneh, Osama ; Gharaibeh, Almutez ; Sharif, Zuhair ; Meqbil, Jehad ; AlShawabkeh, Mo'ath ; Alwreikat, Amal ; Al Bdour, Muawyah ; Al-Hussaini, Maysa ; Yousef, Yacoub A
Subjects: Age ; Bioethics ; Care and treatment ; Coronaviruses ; COVID-19 ; covid-19 lockdown ; covid-19 pandemic ; Diabetes ; Diabetic retinopathy ; Disease ; Edema ; Endothelial growth factors ; Ethical aspects ; Ethics ; Hemoglobin ; Hospitals ; intravitreal injection ; Macular degeneration ; macular edema ; Medical personnel ; Medical research ; Medicine, Experimental ; Original Research ; Pandemics ; Patients ; Povidone ; Questionnaires ; Severe acute respiratory syndrome coronavirus 2 ; Tomography ; Veins & arteries ; Virus diseases
Is Part Of: Clinical ophthalmology (Auckland, N.Z.), 2021-01, Vol.15, p.661-669
Description: To assess the impact of Jordanian's Corona Virus Disease (COVID-19) lockdown on visual acuity and macular thickness in patients with macular edema receiving intravitreal injections, and to assess the ethical endeavor of lockdown among serious sight threatening conditions. This retrospective observational study included patients planned for intravitreal injections who did not complete the planned course before the lockdown (ie, before 20th of March 2020). Data included demographics, indication for the intravitreal injection, corrected distance visual acuity (CDVA), and central macular thickness on Optical Coherence Tomography (OCT) before and after the lockdown. One-hundred and sixty-six eyes of 125 patients were studied, 68 (54.4%) patients were males, and the mean (± standard deviation, SD) age was 64.79 (±9.41) years. Mean (±SD) duration of delay in the planned injection was 60.97 (±24.35) days. The change in visual acuity was statistically significant for patients with diabetic macular edema (p= 0.045 improvement), patients with central retinal vein thrombosis (CRVO) (p= 0.05 deterioration), and patients with age-related macular degeneration (AMD) (p= 0.005 deterioration). Of interest, delay of more than 2 months and the previous need for 3 or more injections were significant poor prognostic factors for visual outcome for patients with diabetic macular edema (p=0.027 and 0.045). The impact of delay in the scheduled intravitreal injections resulted in variable outcomes depending on the indication. Triaging the urgency of patients should be based on the indication to support the equity principle of bioethics, where those in need are prioritized against others, depending on potential adverse outcome.
Publisher: New Zealand: Dove Medical Press Limited
Language: English
Identifier: ISSN: 1177-5467
ISSN: 1177-5483
EISSN: 1177-5483
DOI: 10.2147/OPTH.S289068
PMID: 33628009
Source: Open Access: PubMed Central
Geneva Foundation Free Medical Journals at publisher websites
AUTh Library subscriptions: ProQuest Central
Coronavirus Research Database
DOAJ Directory of Open Access Journals
Dove Press Free

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Delayed Intravitreal Anti-VEGF Therapy for Patients During the COVID-19 Lockdown: An Ethical Endeavor

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