Advice for people currently receiving Anti-VEGF treatment for Neovascular Age-related Macular Degeneration (nAMD) or Diabetes-related Macular Edema (DME).
The majority of people affected by nAMD and DME are 65 years and older. Many have been asked to stay home and self-isolate as, in the context of the COVID-19 pandemic, they belong to a vulnerable community. Retina International understands that this is an extremely difficult time for those living with severe vision impairment. There is much fear and unfortunately a lot of misinformation circulating. What we do know is that people with underlying lung and heart conditions and other serious diseases, and in particular those aged over 65 years are more likely to experience complications if they contract the COVID-19 virus.
Older people with nAMD and DME, especially those who also have lung or heart diseases should take extra care to minimize their exposure to the virus. Retina International and its Scientific and Medical Advisory Board recommends that you access information through trusted sources such as your local health ministries and The World Health Organization (WHO).
Recommendations from the WHO include:
- Wash your hands frequently with soap and water or an alcohol-based hand rub
- Avoid touching your eyes, nose and mouth unless your hands are clean
- Try to keep at least 2-meter distance between yourself and others, particularly to those who are coughing and/or sneezing
- When coughing and/or sneezing, cover your mouth and nose with a flexed elbow or tissue
- Practice food safety by using different chopping boards for raw meat and cooked foods and wash your hands between handling them.
- Avoid public gatherings and crowds
- Avoid using public transport where possible
- Where possible, use alternatives to face-to-face routine medical appointments (for example, telephone appointments).
While the importance of ongoing Anti-VEGF treatment for those currently receiving injections is critical to the preservation of vision and eye health, current advice on attending treatment appointments varies from country to country and region to region. In some macular conditions delays of treatment may be indeed acceptable from a medical viewpoint, in others uninterrupted treatment is indispensable. With this in mind the Retina International Scientific and Medical Advisory Board is recommending that patients check with their eye doctor’s or eye clinic to establish if there will be change to an appointment now or in the future. Do not assume the appointment has been cancelled. Should your next appointment have been delayed or cancelled for whatever reason, it is recommended that you continuously check your vision yourself. Test daily each eye separately with the Amsler grid, as described by the American Academy of Ophthalmology:
https://www.aao.org/eye-health/tips-prevention/facts-about-amsler-grid-daily-vision-test
If you notice that your vision has unambiguously changed, e.g. if any areas of the Amsler grid that were fine the day before suddenly appear darker, wavy, blank or blurry, contact your ophthalmologist right away.
*This advice will be reviewed regularly and updated as evidence about COVID-19 becomes available.
Prof. Dr. E. Zrenner
Chair, Retina International Scientific and Medical Advisory Board
Zurich/Dublin/Tuebingen, 21th march 2020