Delayed Intravitreal Anti-VEGF Therapy for Patients During the COVID-19 Lockdown: An Ethical Endeavor
| Autor: | Robert Rejdak, Yacoub A. Yousef, Mutasem Elfalah, Mo'ath AlShawabkeh, Sandrine Zweifel, Jehad Meqbil, Saif Aldeen AlRyalat, Amal Alwreikat, Muawyah D Al Bdour, Mario Damiano Toro, Maysa Al-Hussaini, Mohammed Abu-Ameerh, Osama H. Ababneh, Rashed Mustafa Nazzal, Almutez M. Gharaibeh, Zuhair Sharif |
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| Přispěvatelé: | University of Zurich, Elfalah, Mutasem, Toro, Mario Damiano, Elfalah, M., Alryalat, S. A., Toro, M. D., Rejdak, R., Zweifel, S., Nazzal, R., Abu-Ameerh, M., Ababneh, O., Gharaibeh, A., Sharif, Z., Meqbil, J., Alshawabkeh, M., Alwreikat, A., Bdour, M. A., Al-Hussaini, M., Yousef, Y. A. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
10018 Ophthalmology Clinic
medicine.medical_specialty Visual acuity Distance visual acuity Central retinal vein thrombosis Coronavirus disease 2019 (COVID-19) genetic structures macular edema 610 Medicine & health 03 medical and health sciences 0302 clinical medicine covid-19 lockdown Ophthalmology medicine Ethic Macular edema Original Research Anti vegf business.industry covid-19 pandemic intravitreal injection Retrospective cohort study Clinical Ophthalmology Macular degeneration RE1-994 medicine.disease 2731 Ophthalmology ethics eye diseases 030221 ophthalmology & optometry medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Clinical Ophthalmology, Vol Volume 15, Pp 661-669 (2021) Clinical Ophthalmology (Auckland, N.Z.) |
| DOI: | 10.5167/uzh-209866 |
| Popis: | Mutasem Elfalah,1 Saif Aldeen AlRyalat,1 Mario Damiano Toro,2– 4 Robert Rejdak,4 Sandrine Zweifel,3 Rashed Nazzal,5 Mohammed Abu-Ameerh,1 Osama Ababneh,1 Almutez Gharaibeh,1 Zuhair Sharif,1 Jehad Meqbil,1 Mo’ath AlShawabkeh,1 Amal Alwreikat,6 Muawyah Al Bdour,1 Maysa Al-Hussaini,7 Yacoub A Yousef8 1Department of Special Surgery, Faculty of Medicine, The University of Jordan, Amman, Jordan; 2Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan WyszyÅski University, Warsaw, Poland; 3Department of Ophthalmology, University Hospital of Zürich, Zürich, Switzerland; 4Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland; 5Shami Eye Center, Amman, Jordan; 6Department of Ophthalmology, Royal Medical Services, Amman, Jordan; 7Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan; 8Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman, JordanCorrespondence: Mutasem ElfalahDepartment of Special Surgery, Faculty of Medicine, The University of Jordan, Queen Rania St, Amman, 11941, JordanTel +96265355000Email mutasemrabie@hotmail.comMario Damiano ToroDepartment of Ophthalmology, University Hospital of Zürich, Raemistrasse 100, Zürich, 8091, SwitzerlandTel +39 3495158220Email toro.mario@email.itPurpose: 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.Patients and Methods: 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.Results: 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).Conclusion: 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.Keywords: COVID-19 lockdown, COVID-19 pandemic, ethics, intravitreal injection, macular edema |
| Databáze: | OpenAIRE |
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