Changes in demographics and treatment trends in neovascular age-related macular degeneration during the COVID-19 pandemic in Japan

Abstract Purpose To elucidate changes in the management of neovascular age-related macular degeneration (nAMD) in Japan during the COVID-19 pandemic . Study design Retrospective cohort study. Methods We conducted a multicenter retrospective cohort study of patients newly examined at 16 retina specialist facilities from January 2017 to March 2021. Baseline findings and 3-year follow-up data were compared between pre-pandemic (2017–February 2020) and post-pandemic (March 2020–March 2021) groups. Results Analysis of 2271 patients with nAMD revealed a significant decrease in the number of patients examined at hospitals during the COVID-19 pandemic period (p = 0.011), along with a higher proportion of patients who had received treatment within the previous year at local clinics. Baseline ocular findings showed no significant differences between the pre- and post-pandemic groups. Loss to follow-up increased through the second year of the pandemic period (first year, p = 0.0012; second year, p = 0.023). No significant differences were observed during follow-up in visual acuity, central retinal thickness, or number of anti–vascular endothelial growth factor injections. However, in the post-pandemic period the frequency of photodynamic therapy tended to decrease, and examination visits decreased significantly (p = 0.0038). Conclusion The number of nAMD patients treated in hospitals was lower in the post-pandemic period, and the proportion managed initially in local clinics increased. Although baseline and follow-up characteristics remained largely similar, the use of photodynamic therapy and the number of follow-up visits declined. These findings suggest a shift in the initial nAMD management from hospitals to local clinics during the early post-pandemic period.