The impact of coronavirus disease (COVID-19) pandemic on intravitreal injections treatment for macular diseases: report from a referral hospital in Milan

Purpose: To describe our managing strategy for COVID-19 emergency, to evaluate the adherence to intravitreal treatment (AtT) rate during the outbreak in a referral hospital in Milan and to correlate it with patients clinical features. Methods: AtT rate of patients with scheduled intravitreal injections (IVT) during the COVID-19 outbreak from 23/02/20 to 31/03/20 was compared to the previous trimester and with March 2019. The impact of age, sex, visual function and diagnosis on the AtT rate during unlocked/locked weeks (from March 8) was evaluated. Results: Of 650 consecutive patients with scheduled IVT, AtT rate during the COVID-19 outbreak was 0.37. This was significantly lower compared to AtT registered in the previous trimester (0.92) and in the same weeks in 2019 (0.90) (both p <0.001). Patients adherent to treatment were significantly younger (p<0.001) and had a lower best-corrected visual acuity in the fellow eye (p=0.046). During the lockdown weeks AtT rate was significantly lower than in the two unlocked weeks (0.19 vs 0.73, p<0.001). In addition, the AtT rate in patients classified as "Emergent" during the lockdown weeks was 0.60. Conclusions: These preliminary results can help the retina specialist community to foresee this unique scenario and to develop successful management strategies.