summary

The coronavirus disease 2019 (COVID-19) pandemic emerged in France in February 2020. On March 17, 2020, a national population lockdown restricted human contacts and travel to a strict minimum until May 11, 2020. Many patients experienced difficulties or fear of accessing health care during lockdown.¹ We hypothesized that the COVID-19 pandemic may have modified the dispensing of intravitreal (IVT) anti–vascular endothelial growth factors (anti-VEGF), the main treatment for retinal vascular abnormalities.² This study quantified changes in the use of IVT anti-VEGF since the pandemic began in France.

results

The study found that 33 292 individuals used IVT anti-VEGF drugs in 2020 before lockdown (20 146 women [60.5%]; mean [SD] age, 77.3 [11.1] years), 87 316 during lockdown (52 461 women [60.1%]; mean [SD] age, 76.8 [11.0] years), and 63 020 during reopening (38 593 women [61.2%]; mean [SD] age, 77.5 [11.0] years). Compared with expected numbers, observed numbers of individuals using IVT anti-VEGF markedly decreased by up to 47.1% (a decrease of 7432 patients) during the 5 first weeks of lockdown (weeks 12-16, 2020) and remained at a low level until the last week of lockdown (−24.9% [4424 fewer patients] during week 19). During the 8 weeks of lockdown, the shortfall represented a decrease of 46 381 injections. A gradual but incomplete recovery was observed in the first 4 weeks of reopening (difference of −21.9% [4247 fewer patients] in week 20 to −4.2% [723 fewer patients] and −3.5% [581 fewer patients] in weeks 22 and 23). Baseline sex and age characteristics of the patient cohort remained similar for each period. The decrease was particularly marked (−65.3%) for treatment initiations during lockdown. This decrease corresponds to a total of 8169 fewer treatment initiations during the lockdown period. A gradual recovery was observed during reopening.