The response to the evolving coronavirus disease 2019 (COVID-19) pandemic required rapid restructuring of clinical practice in order to allow for increased critical care capacity and resource repurposing, while limiting transmission risk within the clinical environment. Ensuring uninterrupted healthcare provision in the context of high-risk diseases requiring frequent treatment, such as neovascular age-related macular degeneration (nAMD), necessitated reorganization of monitoring and treatment protocols. Accordingly, following lockdown imposition by the UK government, the Royal College of Ophthalmologists published initial guidance recommending maintenance on 8-weekly treatment for all patients with nAMD already receiving anti-vascular endothelial growth factor (anti-VEGF) injections [1]. No clinical assessment was deemed necessary, unless there was subjective impression of reduced visual function [1]. This guidance was revised at the end of the first pandemic wave [2] to permit return to pre-pandemic normality, however this plan was hampered by the subsequent resurgence of COVID-19. It is therefore essential to investigate the effect of implementing such changes on clinical outcomes in order to evaluate any visual loss suffered as an indirect result of COVID-19. We believe this information may guide further service reconfiguration in case future pandemic waves necessitate the reinstatement of similar contingency plans.

An audit on visual outcomes of 513 eyes of 419 patients treated with intravitreal anti-VEGF for choroidal neovascularization (CNV) at Royal Liverpool University Hospital during the first lockdown period was conducted. Patients with booked clinic appointments during the first 5 weeks after lockdown enforcement on March 23rd, 2020 (https://www.instituteforgovernment.org.uk/sites/default/files/timeline-lockdown-web.pdf), were selected and outcomes were followed up until their first visit after termination of the UK government-proposed shielding period on July 4th, 2020. During this period, clinicians triaged clinics in advance and telephoned patients to encourage or defer attendance.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account
Continue with Google
Continue with ORCiD