Groppe Markus, Bindra Mandeep Singh
Retina Unit, Buckinghamshire Healthcare NHS Trust, Stoke Mandeville and Amersham Hospital, Aylesbury, HP21 8AL, UK.
Clin Ophthalmol. 2021 Feb 17;15:651-659. doi: 10.2147/OPTH.S269596. eCollection 2021.
COVID-19 has had a major impact on health-care provision. Social distancing will impact the organization of outpatient clinics (OCs) and require general restructuring of health care.
Our retinal team participated in a structured fact-finding session to implement social distancing of patients and staff in wet age-related macular degeneration (wAMD) clinics. Clinic flow and performance were continually reviewed and improved. A retrospective audit of all wAMD follow-up appointments was conducted for 4 weeks from the start of the UK lockdown. A search for clinical guidance regarding retinal services was performed on the homepages of international professional bodies. The guidelines were compared to the implemented changes in our wAMD social distancing OCs (SDOCs) and potential risk examined.
The changes in clinic setup to achieve SDOCs are described. The average total time spent in the clinic area by each patient has reduced by 27%. The audit concluded that 65% of patients needed a treatment interval of 4-7 weeks after their appointment, 17% at either 8 or 9 weeks, and 18% at 10 weeks or beyond. The UK, Australian-New Zealand, US, and German professional ophthalmology bodies have published divergent guidelines, but all recommended a continuation of anti-VEGF injections.
Health-care provision will change and hospitals and outpatient facilities will have to adapt to the COVID-19 epidemic. We describe a clinic setup (SDOCs) that minimizes risk to patients and staff, while maintaining the ability to treat each patient and their disease individually.
新型冠状病毒肺炎（COVID-19）对医疗服务产生了重大影响。社交距离措施将影响门诊诊所（OCs）的组织架构，并要求对医疗保健进行全面重组。
我们的视网膜团队参与了一次结构化的实情调查会议，以在湿性年龄相关性黄斑变性（wAMD）诊所中实施患者和工作人员的社交距离措施。持续审查并改进了诊所流程和绩效。从英国封锁开始后的4周内，对所有wAMD随访预约进行了回顾性审计。在国际专业机构的主页上搜索了有关视网膜服务的临床指南。将这些指南与我们的wAMD社交距离门诊诊所（SDOCs）中实施的变更进行比较，并检查潜在风险。
描述了为实现社交距离门诊诊所而对诊所设置所做的更改。每位患者在诊所区域花费的平均总时间减少了27%。审计得出结论，65%的患者在预约后需要4至7周的治疗间隔，17%的患者需要8或9周，18%的患者需要10周或更长时间。英国、澳大利亚-新西兰、美国和德国的专业眼科机构发布了不同的指南，但都建议继续进行抗血管内皮生长因子（VEGF）注射。
医疗服务将发生变化，医院和门诊设施将不得不适应COVID-19疫情。我们描述了一种诊所设置（社交距离门诊诊所），该设置可将患者和工作人员的风险降至最低，同时保持对每位患者及其疾病进行个体化治疗的能力。
