Tan A C S, Schwartz R, Anaya D, Chatziralli I, Yuan M, Cicinelli M V, Faes L, Mustapha M, Phasukkijwatana N, Pohlmann D, Reynolds R, Rosenblatt A, Savastano A, Touhami S, Vaezi K, Ventura C V, Vogt D, Ambati J, de Smet M D, Loewenstein A
Singapore National Eye Centre, Singapore, Singapore.
Singapore Eye Research Institute, Singapore, Singapore.
Int J Retina Vitreous. 2022 Jun 7;8(1):33. doi: 10.1186/s40942-022-00380-6.
Tertiary outpatient ophthalmology clinics are high-risk environments for COVID-19 transmission, especially retina clinics, where regular follow-up is needed for elderly patients with multiple comorbidities. Intravitreal injection therapy (IVT) for chronic macular diseases, is one of the most common procedures performed, associated with a significant burden of care because of the vigorous treatment regimen associated with multiple investigations. While minimizing the risk of COVID-19 infection transmission is a priority, this must be balanced against the continued provision of sight-saving ophthalmic care to patients at risk of permanent vision loss. This review aims to give evidence-based guidelines on managing IVT during the COVID-19 pandemic in common macular diseases such as age-related macular degeneration, diabetic macula edema and retinal vascular disease and to report on how the COVID-19 pandemic has affected IVT practices worldwide.To illustrate some real-world examples, 18 participants in the International Retina Collaborative, from 15 countries and across four continents, were surveyed regarding pre- and during- COVID-19 pandemic IVT practices in tertiary ophthalmic centers. The majority of centers reported a reduction in the number of appointments to reduce the risk of the spread of COVID-19 with varying changes to their IVT regimen to treat various macula diseases. Due to the constantly evolving nature of the COVID-19 pandemic, and the uncertainty about the normal resumption of health services, we suggest that new solutions for eye healthcare provision, like telemedicine, may be adopted in the future when we consider new long-term adaptations required to cope with the COVID-19 pandemic.
三级眼科门诊是新冠病毒传播的高风险环境，尤其是视网膜门诊，那里需要对患有多种合并症的老年患者进行定期随访。玻璃体内注射疗法（IVT）用于治疗慢性黄斑疾病，是最常见的手术之一，由于与多项检查相关的严格治疗方案，其护理负担很重。虽然将新冠病毒感染传播风险降至最低是首要任务，但这必须与继续为有永久性视力丧失风险的患者提供挽救视力的眼科护理相平衡。本综述旨在给出基于证据的指南，指导在新冠疫情期间如何管理常见黄斑疾病（如年龄相关性黄斑变性、糖尿病性黄斑水肿和视网膜血管疾病）的玻璃体内注射疗法，并报告新冠疫情如何影响全球的玻璃体内注射疗法实践。为了举例说明一些实际情况，对来自四大洲15个国家的国际视网膜协作组织的18名参与者进行了调查，了解他们在三级眼科中心新冠疫情之前和期间的玻璃体内注射疗法实践情况。大多数中心报告称减少了预约数量，以降低新冠病毒传播风险，同时对治疗各种黄斑疾病的玻璃体内注射疗法方案进行了不同程度的调整。由于新冠疫情的不断演变，以及卫生服务正常恢复的不确定性，我们建议，在考虑应对新冠疫情所需的新的长期适应性措施时，未来可能会采用远程医疗等新的眼科医疗服务解决方案。
