ArticleEye (London, England)2026
Predictive factors for visual acuity in diabetic macular oedema: lessons for clinical practice learned from deferring intravitreal injections under the COVID-19 pandemic.
Article in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDiabetic macular oedema (DMO) is a leading cause of visual impairment globally. The COVID-19 pandemic significantly disrupted routine clinical care, including regular intravitreal therapy (IVT) for DMO. This study analysed real-world data from patients whose treatments were deferred due to the pandemic 18 months post-disruption.
methodsPatients scheduled for initiation or continuation of aflibercept IVT for DMO at a single centre during the March 2020 lockdown were identified and recruited. Clinical data were collected from January 2019 until September 2021. The primary outcome was best corrected visual acuity (BCVA) at the final visit and its predictive factors.
resultsA total of 416 eyes from 416 patients were included (random eye/patient). The mean interval between injections increased significantly during the pandemic, with worsening of mean logMAR BCVA [55 days in 2019 (range 25-302), BCVA 0.36; 86 days in 2020 (range 21-681), BCVA 0.41; and 84 days in 2021 (range 24-885), BCVA 0.45]. However, there was no significant difference when comparing mean BCVA at baseline (0.42 ± 0.3) and final visit (0.41 ± 0.3). Significant predictors of final BCVA included baseline BCVA (0.059 logMAR increase per 0.1 logMAR baseline increase, p < 0.001), follow-up duration (0.038 logMAR increase per additional 6 months, p < 0.001), age at baseline (0.037 logMAR increase per decade, p = 0.001), and ethnicity (White ethnicity had 0.061 logMAR better BCVA compared to non-White groups, p = 0.04).
conclusionsExtended intervals between aflibercept injections during COVID-19 did not independently predict worse visual outcomes. Baseline BCVA, age, and ethnicity were significant predictive factors.
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