Impact of the COVID-19 pandemic on patients receiving intravitreal injections

Authors

  • Ningzhi Zhang Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China https://orcid.org/0000-0002-9570-4726
  • Xuejun He Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
  • Yiqiao Xing Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
  • Ning Yang Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China https://orcid.org/0000-0003-3036-0202

DOI:

https://doi.org/10.2298/ABS220116003Z

Keywords:

anti-vascular endothelial growth factor (VEGF), COVID-19, intravitreal injection, post-injection endophthalmitis, vial splitting

Abstract

Paper description:

  • Splitting one vial of anti-vascular endothelial growth factor (VEGF) is no longer carried out after COVID-19, exerting increased financial pressure on patients receiving anti-VEGF intravitreal injections (IVIs).
  • The cost and incidence of post-injection endophthalmitis (PIE) before and after the pandemic were analyzed in a retrospective study.
  • A single vial used for only one patient dramatically increased the financial burden on IVI patients but did not reduce PIE incidence.
  • After the COVID-19 pandemic has been contained, splitting vials into syringes for IVI patients could resume.

Abstract: We analyzed the economic benefits versus safety risks of sharing anti-vascular endothelial growth factor (VEGF) vials during the coronavirus disease (COVID-19) pandemic. This single-center retrospective study analyzed the data of patients with neovascular age-related macular degeneration (nAMD), proliferative diabetic retinopathy (PDR) and retinal vein occlusion (RVO) who received anti-VEGF between January 2016 and July 2021 at Renmin Hospital, Wuhan University, China. Costs were compared of the two protocols of intravitreal injections (IVIs) of ranibizumab, aflibercept and conbercept after (i) splitting the vial content for use in two patients and after (ii) disposal of the remaining vial content after use in a single patient, with the COVID-19 outbreak considered as the demarcation point. The incidence rates of post-injection endophthalmitis (PIE) pre- and post-outbreak were analyzed. The mean cost of a single IVI increased by 33.3%, from 3917.67±71.69 to 5222.67±84.98 Chinese Yuan during the pandemic. The incidences of IVI-related culture-positive PIE were 0.0134% (3 in 22448) and 0.0223% (1 in 4479), respectively, before and after the pandemic (P=0.6532). We conclude that vial sharing of IVIs in a large clinical institution is not associated with increased PIE risk and can significantly reduce the cost of therapy.

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Published

2022-04-01

How to Cite

1.
Zhang N, He X, Xing Y, Yang N. Impact of the COVID-19 pandemic on patients receiving intravitreal injections. Arch Biol Sci [Internet]. 2022Apr.1 [cited 2022Jul.6];74(1):49-55. Available from: https://www.serbiosoc.org.rs/arch/index.php/abs/article/view/7412

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