Impact of the COVID-19 pandemic on the Andalusian program for early detection of diabetic retinopathy: a population-based study.

Aims: To analyze the impact of the COVID-19 pandemic on the activity and outcomes of the Andalusian Program for Early Detection of Diabetic Retinopathy (APDR).

Methods: A retrospective observational study was conducted during 2018-2023. The following variables were analyzed annually: newly included patients, retinal photographs performed, and pathological findings categorized by severity. Moderate-to-severe non-proliferative and proliferative retinopathy were classified as vision-threatening diabetic retinopathy (VTDR).

Results: In 2020 and 2021, the number of newly included patients (11,897 and 18,343, respectively) and retinal photographs performed (39,667 and 64,092, respectively) decreased compared to previous years (2018 and 2019: 25,940 and 30,807 new patients, respectively; 85,171 and 100,849 retinal photographs, respectively). In 2022, activity levels increased 160% compared to 2019. The proportion of VTDR cases remained stable at 0.163%, 0.14%, and 0.075% during 2021, 2022, and 2023, respectively, compared to the prepandemic period (0.168% and 0.117% in 2018 and 2019, respectively).

Conclusions: Despite the slowdown in activity during the COVID-19 pandemic, the post-pandemic proportion of VTDR cases diagnosed through the APDR remained stable, suggesting resilience against severe outcomes despite healthcare disruption. The program has demonstrated an effective recovery. Ongoing long-term monitoring is essential to fully assess the pandemic's potential impact on late-stage complications.