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Visioli G, Zeppieri M, Iannucci V, Manni P, Albanese GM, Salati C, Spadea L, Pirraglia MP. From Bedside to Diagnosis: The Role of Ocular Fundus in Systemic Infections. J Clin Med 2023; 12:7216. [PMID: 38068267 PMCID: PMC10707096 DOI: 10.3390/jcm12237216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 01/23/2024] Open
Abstract
In this comprehensive review, we delve into the significance of the ocular fundus examination in diagnosing and managing systemic infections at the bedside. While the utilization of advanced ophthalmological diagnostic technologies can present challenges in bedside care, especially for hospitalized patients confined to their beds or during infection outbreaks, the ocular fundus examination often emerges as an essential, and sometimes the only practical, diagnostic tool. Recent discussions have highlighted that the role of an ocular fundus examination might not always be advocated as a routine diagnostic procedure. With this context, we introduce a decision tree tailored for assessing the ocular fundus in inpatients with systemic infections. We also present an overview of systemic infections that impact the eye and elucidate key signs detectable through a bedside ocular fundus examination. Targeted primarily at non-ophthalmology clinicians, this review seeks to offer a comprehensive insight into a multifaceted approach and the enhancement of patient clinical outcomes.
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Affiliation(s)
- Giacomo Visioli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Valeria Iannucci
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Priscilla Manni
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Giuseppe Maria Albanese
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Leopoldo Spadea
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
- Eye Clinic, Policlinico Umberto I University Hospital, 00161 Rome, Italy
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Bonilla-Escobar FJ, Sánchez-Cano D, Lasave AF, Soria J, Franco-Cárdenas V, Reviglio VE, Dantas PEC, Palacio Pastrana C, Corbera JC, Chan RY, Diaz AL, Garcia Hernandez M, Maia M, Carpentier C, Wu L, Sanchez M, Murillo Sasamoto M, Murillo Azcárraga G, Roca JA, Serrano MA, Alezzandrini AA, Sanchez Montoya JG, Gabela G, Garcia-Aguirre G, Arevalo JF. Early-Phase Perceptions of COVID-19's Impact on Ophthalmology Practice Patterns: A Survey from the Pan-American Association of Ophthalmology. Clin Ophthalmol 2023; 17:3249-3259. [PMID: 37927574 PMCID: PMC10625333 DOI: 10.2147/opth.s434776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose The COVID-19 pandemic affected medical practice worldwide due to interventions to prevent spreading. Its effect on ophthalmology practices in Latin America has not yet been explored. We aimed to assess the perceptions about the pandemic from countries' ophthalmological national and subspecialty retina societies affiliated to the Pan-American Association of Ophthalmology (PAAO). Patients and Methods A survey-based study of leaders of national ophthalmological and retinal societies was conducted. The survey was sent by email to 30 societies, from which 20 responded (12 countries, 66.6% response rate). It included closed- and open-ended questions about (1) operational capacity and precautions, (2) telemedicine and virtual care, (3) procedures, and (4) post-pandemic considerations. Results There was a marked decline in ophthalmology patient visits (80-95%) and elective surgeries (90%) during 2020 compared to before the pandemic. Precautions like temperature checks, mask usage, and social distancing were widely implemented while personal protective equipment (PPE) availability varied. Telemedicine use was limited due to lack of experience with it. Reopening plans focused on maintaining precautions and gradually resuming activities. Economic and security concerns were raised, and adherence to guidelines was emphasized. Respondents acknowledged the need to adapt to a "new normal". Long duration drugs, fewer imaging studies, and shorter wait times were preferred; however, availability of long duration drugs was limited. Conclusion The pandemic impacted ophthalmology in Latin America, with reduced patient visits, procedures, and surgeries. Delayed treatment and complications were likely the result of the pandemic.
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Affiliation(s)
- Francisco Javier Bonilla-Escobar
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia
- Ophthalmology Department, Institute for Clinical Research Education, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Vision y Salud Ocular, VISOC, Ophthalmology Department, Universidad del Valle, Cali, Colombia
| | - Daniel Sánchez-Cano
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia
| | - Andres F Lasave
- The Retina and Vitreous Department, Private Eyes Clinic, Mar del Plata, Argentina
| | - Jaime Soria
- Ophthalmology Department, Clínica Real Visión, Uniofken, CIVE y Funcrisa, Guayaquil, Ecuador
| | | | - Victor E Reviglio
- Ophthalmology Department, Instituto de la Visión Cerro, Sanatorio Allende Cerro & Universidad Católica de Córdoba, Health Science Faculty, Cordoba, Argentina
| | - Paulo E C Dantas
- Ophthalmology Department, Sorocaba Eye Bank Hospital, Sorocaba, Brazil
| | - Claudia Palacio Pastrana
- Department of Microsurgery of the Anterior Segment, Fundación Hospital Nuestra Señora de la Luz IAP, Mexico City, Mexico
| | | | - Rita Yee Chan
- Ophthalmology Department, Clinica Nacional de Oftalmologia, Panama City, Panama
| | - Alberto Luis Diaz
- Ophthalmology Department, Complejo Medico FOSCAL Internacional, Floridablanca, Santander, Colombia
| | | | - Mauricio Maia
- Ophthalmology Department, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Cristian Carpentier
- Ophthalmology Department, Fundación Oftalmológica Los Andes, Santiago, Chile
| | - Lihteh Wu
- Retina Department, Asociados de Macula Vitreo y Retina de Costa Rica, San Jose, Costa Rica
| | - Martin Sanchez
- Ophthalmology Department, Hospital de Minas, Montevideo, Uruguay
| | | | | | - Jose A Roca
- Ophthalmology Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Martin A Serrano
- Retina Department, Centro Médico Docente La Trinidad, Caracas, Venezuela
| | - Arturo A Alezzandrini
- Ophthalmology Department, OFTALMOS, Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina
| | - Juan Gonzalo Sanchez Montoya
- Ophthalmology Department, Instituto Nacional de Investigacion en Oftalmologia –INIO and Clinica Oftalmologica de Antioquia, Medellin, Colombia
| | - Gregorio Gabela
- Ophthalmology Department, Hospital Metropolitano, Quito, Ecuador
| | - Gerardo Garcia-Aguirre
- Retina Department, School of Medicine, Tecnológico de Monterrey Asociación Para Evitar la Ceguera en México, Mexico City, Mexico
| | - J Fernando Arevalo
- Ophthalmology Department, Johns Hopkins University, Wilmer Eye Institute, Baltimore, MD, USA
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