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Au A, Bajar BT, Wong BM, Daskivich LP, Hosseini H, Prasad PS. Systemic and ocular outcomes in patients with young-onset type 2 diabetes. J Diabetes Complications 2024; 38:108670. [PMID: 38219336 DOI: 10.1016/j.jdiacomp.2023.108670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 11/03/2023] [Accepted: 12/17/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE To analyze the systemic and ocular outcomes in patients with young-onset type 2 diabetes (YO-DM2) based on grade of presenting diabetic retinopathy (DR). METHODS Retrospective cohort study analysis of empaneled patients with type 2 diabetes <40 years old with retinopathy screening within the Los Angeles Department of Health Services between 01/01/2017-07/01/2021 were included. Patients were stratified based on presenting severity of DR determined on fundus photographs or clinical examination. Patient's systemic co-morbidities and ocular outcomes were then compared across each group. Procedural (e.g. intravitreal injections) and surgical interventions (e.g. pars plana vitrectomy) were documented as performed by the treating physician. RESULTS 2795 patients were screened from 12,456 patients diagnosed with diabetes younger than age 40 (22.4 %). Of these, 1496 patients were diagnosed with type 2 DM. 1084 (72.4 %) of patients presented without DR, 307 (20.5 %) presented with non-proliferative diabetic retinopathy (NPDR), and 105 (7.0 %) of patients presented with proliferative diabetic retinopathy (PDR). Increasing presenting diabetic retinopathy severity was associated with longer duration of diabetes, greater systemic comorbidities (e.g. diabetic foot disease, neuropathy, chronic kidney or end stage renal disease), worse baseline and final visual acuity, and required more procedural and surgical interventions. CONCLUSIONS Worse presenting DR severity in patients young-onset type 2 diabetes was associated with greater comorbid systemic and ocular disease with worse visual acuity outcomes. <1 % of patients without diabetic retinopathy or with mild NPDR were likely to progress to PDR. Diabetic kidney disease was an independent risk factor for developing neovascular glaucoma and retinal detachments. Prompt evaluation and intervention in patients with YO-DM2 may help reduce the associated systemic and ocular morbidity.
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Affiliation(s)
- Adrian Au
- Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States of America; Division of Ophthalmology, Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Bryce T Bajar
- Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Brittany M Wong
- Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Lauren P Daskivich
- Los Angeles County Department of Health Services, Los Angeles, CA, United States of America
| | - Hamid Hosseini
- Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States of America; Division of Ophthalmology, Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Pradeep S Prasad
- Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States of America; Division of Ophthalmology, Harbor-UCLA Medical Center, Torrance, CA, United States of America.
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Vashist K, Frediani JK, Weber MB, Ali MK, Narayan KMV, Patel SA. Changes in Diabetes Care and Management Practices during the COVID-19 Pandemic. RESEARCH SQUARE 2024:rs.3.rs-3849240. [PMID: 38313263 PMCID: PMC10836114 DOI: 10.21203/rs.3.rs-3849240/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Background Evidence suggests diabetes management was negatively impacted early in the pandemic. However, the impact of the pandemic on key healthcare services for diabetes control and diabetes self-management practices is less known. We examined changes in diabetes care and management practices before and during the COVID-19 pandemic. Methods Population-based data regarding 4 diabetes-related healthcare engagement and 4 self-management indicators were obtained from adults with diabetes surveyed in 19 US States and Washington DC through the Behavioral Risk Factor Surveillance System. Using logistic regression, we estimated changes in the prevalence of each indicator, overall and by sociodemographic subgroups, before (2019; n = 15,307) and during (2021; n = 13,994) the COVID-19 pandemic. Results Between 2019 and 2021, the prevalence of biannual HbA1c tests reduced by 2.6 percentage points (pp, 95% CI :-4.8, -0.4), from 75.4-73.1%, and prevalence of annual eye exams fell by 4.0 pp (-6.2, -2.8), from 72.2-68.7%. The composite indicator of engagement with healthcare for diabetes control fell by 3.5 pp (-5.9, -1.1), from 44.9-41.9%. Reductions in engagement with healthcare were largely seen across sex, age, education, employment status, marital status, insurance status, and urbanicity; and were more pronounced among those aged 18-34 and the uninsured. Reductions in engagement with healthcare were seen in several states, with Delaware and Washington DC reporting the largest decrease. Of self-management behaviors, we only observed change in avoidance of smoking, an increase of 2.0 pp (0.4, 3.6) from 84.7-87.1%. Conclusions The pandemic had mixed impacts on diabetes care and self-management. The findings suggest a deterioration of the uptake of evidence-based, preventive health services requiring laboratory services and clinical examination for diabetes control during the pandemic. On the other hand, smoking rates decreased, suggesting potential positive impacts of the pandemic on health behaviors in people with diabetes.
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Chuter BG, Lieu A, Dayao JKO, Bu JJ, Chen K, Nishihara T, Baxter SL. Impact of COVID-19 on the Delivery of Eye Care to Uninsured Diabetic Patients at a Student-Run Free Clinic: A Comprehensive Evaluation of Eye Clinic Performance. JOURNAL OF STUDENT-RUN CLINICS 2022; 8:358. [PMID: 36890867 PMCID: PMC9991481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Background Diabetic retinopathy is the leading cause of blindness among working-age adults in the United States and requires timely screening and management. This study evaluates the impact of the coronavirus disease 2019 (COVID-19) pandemic on diabetic retinopathy screening (DRS) for uninsured, predominantly Latino patients at the University of California San Diego Student-Run Free Clinic Project (SRFCP). Methods A retrospective chart review was conducted of all living diabetic patients at SRFCP who were seen in 2019 (n=196), 2020 (n=183), and 2021 (n=178). Ophthalmology clinic referrals, scheduled patient visits, and visit outcomes were analyzed longitudinally to determine the impact of the pandemic on screening patterns. Results The study population was 92.1% Latino, 69.5% female, with a mean age of 58.7 years. The distribution of patients seen (p<0.001), referred (p=0.012), and scheduled (p<0.001) in 2020 and 2021 significantly differed from 2019. In 2019, 50.5% of 196 patients eligible for DRS were referred, 49.5% were scheduled, and 45.4% were seen. In 2020, 41.5% of 183 eligible patients were referred, but only 20.2% were scheduled and 11.4% were seen. In 2021, there was a rebound: 63.5% of 178 patients were referred, 56.2% scheduled and 46.1% seen. No shows and cancellations represented 12.4% and 6.2% of the 97 encounters scheduled in 2019, but were markedly higher (10.8% and 40.5% respectively) for the 37 encounters scheduled in 2020. Conclusions The COVID-19 pandemic significantly impacted the delivery of eye care at SRFCP. The need for annual DRS exceeded the capacity of the ophthalmology clinic in all years studied, but the difference was especially pronounced with more stringent COVID-19 restrictions in 2020. SRFCP patients could benefit from telemedicine DRS programs to improve screening capacity.
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Affiliation(s)
- Benton G Chuter
- School of Medicine, University of California San Diego, La Jolla, California, USA.,Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
| | - Alexander Lieu
- School of Medicine, University of California San Diego, La Jolla, California, USA.,Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
| | - John Kevin O Dayao
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Jennifer J Bu
- School of Medicine, University of California San Diego, La Jolla, California, USA.,Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
| | - Kevin Chen
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Taiki Nishihara
- School of Medicine, University of California San Diego, La Jolla, California, USA.,Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
| | - Sally L Baxter
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA.,Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
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Romero-Aroca P, Baget-Bernaldiz M, Sagarra R, Hervás E, Blasco R, Molina J, Moreno EF, Garcia-Curto E. Impact of the COVID-19 Pandemic on the Metabolic Control of Diabetic Patients in Diabetic Retinopathy and Its Screening. J Clin Med 2022; 11:jcm11237121. [PMID: 36498696 PMCID: PMC9737650 DOI: 10.3390/jcm11237121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
(1) Background: Diabetic retinopathy (DR) is a complication of diabetes mellitus (DM), screening programs of which have been affected by the COVID-19 pandemic. The aim of the present study was to determine the impact of the COVID-19 pandemic on the screening of diabetes patients in our healthcare area (HCA). (2) Methods: We carried out a retrospective study of patients with DM who had attended the DR screening program between January 2015 and June 2022. We studied attendance, DM metabolic control and DR incidence. (3) Results: Screening for DR decreased in the first few months of the pandemic. The incidence of mild and moderate DR remained stable throughout the study, and we observed little increase in severe DR, proliferative DR and neovascular glaucoma during 2021 and 2022. (4) Conclusions: The current study shows that during the COVID-19 pandemic, screening program attendance decreased during the year 2020, which then recovered in 2021. Regarding the most severe forms of DR, a slight increase in cases was observed, beginning in the year 2021. Nevertheless, we aimed to improve the telemedicine systems, since the conditions of a significant proportion of the studied patients worsened during the pandemic; these patients are likely those who were already poorly monitored.
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Affiliation(s)
- Pedro Romero-Aroca
- Ophthalmology Service, Hospital Universitario Sant Joan de Reus, 43204 Reus, Spain
- Medicine and Surgery Departement, Medicine and Health Science Faculty, Universitat Rovira & Virgili, 43204 Reus, Spain
- Pere Virgili Institute for Health Research (IISPV), 43204 Reus, Spain
- Correspondence:
| | - Marc Baget-Bernaldiz
- Ophthalmology Service, Hospital Universitario Sant Joan de Reus, 43204 Reus, Spain
- Medicine and Surgery Departement, Medicine and Health Science Faculty, Universitat Rovira & Virgili, 43204 Reus, Spain
- Pere Virgili Institute for Health Research (IISPV), 43204 Reus, Spain
| | - Ramon Sagarra
- Pere Virgili Institute for Health Research (IISPV), 43204 Reus, Spain
- Health Care Area Reus-Priorat, Institut Catala de la Salut, 43202 Reus, Spain
| | - Esther Hervás
- Ophthalmology Service, Hospital Universitario Sant Joan de Reus, 43204 Reus, Spain
- Medicine and Surgery Departement, Medicine and Health Science Faculty, Universitat Rovira & Virgili, 43204 Reus, Spain
| | - Reyes Blasco
- Ophthalmology Service, Hospital Universitario Sant Joan de Reus, 43204 Reus, Spain
- Medicine and Surgery Departement, Medicine and Health Science Faculty, Universitat Rovira & Virgili, 43204 Reus, Spain
| | - Julia Molina
- Ophthalmology Service, Hospital Universitario Sant Joan de Reus, 43204 Reus, Spain
- Medicine and Surgery Departement, Medicine and Health Science Faculty, Universitat Rovira & Virgili, 43204 Reus, Spain
| | - Empar F. Moreno
- Ophthalmology Service, Hospital Universitario Sant Joan de Reus, 43204 Reus, Spain
- Medicine and Surgery Departement, Medicine and Health Science Faculty, Universitat Rovira & Virgili, 43204 Reus, Spain
| | - Eugeni Garcia-Curto
- Ophthalmology Service, Hospital Universitario Sant Joan de Reus, 43204 Reus, Spain
- Medicine and Surgery Departement, Medicine and Health Science Faculty, Universitat Rovira & Virgili, 43204 Reus, Spain
- Pere Virgili Institute for Health Research (IISPV), 43204 Reus, Spain
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Wong JKW, Zhu MM, Lam JCH, Leung KMK, Lian JX, Lam CLK, Shih KC, Lai JSM. Prospective Comparative Study Investigating Agreement between Tele-Ophthalmology and Face-to-face Consultations in Patients Presenting with Chronic Visual Loss. Ophthalmol Ther 2022; 11:1199-1213. [PMID: 35416584 PMCID: PMC9006210 DOI: 10.1007/s40123-022-00506-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/28/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction This study aims to investigate the diagnostic accuracy of store-and-forward tele-ophthalmology consultations for non-diabetic patients, aged 40 and above, presenting with vision impairment of 3 months or more, in terms of cataracts, glaucoma, and age-related macular degeneration. Methods This is a prospective comparative study. Enrolled subjects were independently assessed by both tele-ophthalmology and face-to-face assessment. Agreement level between the two modalities for diagnosis and severity were compared using kappa statistic. Diagnostic accuracy of tele-ophthalmology was determined using the face-to-face consultation serving as the gold standard. Costs were compared by calculating the downstream costs generated by each modality in terms of investigations and treatment. Results A total of 860 eyes of 430 patients were assessed during the study period. Tele-ophthalmology consultations had significantly high agreement with face-to-face consultations in the diagnosis and grading of all three ocular conditions; cataracts, glaucoma, and AMD. Diagnosis and grading of cataracts and AMD reached \documentclass[12pt]{minimal}
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\begin{document}$$\kappa$$\end{document}κ values between 0.61 and 0.8. In terms of diagnostic accuracy, tele-ophthalmology consultations were highly sensitive and specific for AMD with greater than 99% sensitivity and specificity achieved by tele-ophthalmology. There was high specificity when diagnosing cataracts, but lower sensitivity at 87.8%. Conversely, there was high sensitivity for diagnosing glaucoma, but lower specificity at 76.5%. Downstream costs were similar between groups. Conclusions Store-and-forward tele-ophthalmology consultations are accurate and comparable to face-to-face consultations for diagnosis and grading of cataracts, glaucoma, and AMD. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00506-x.
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Affiliation(s)
- Jasper Ka-Wai Wong
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 301B Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong SAR
| | - Ming Ming Zhu
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 301B Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong SAR
| | - Jason Chi-Hang Lam
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 301B Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong SAR
| | - Keith Man-Kei Leung
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 301B Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong SAR
| | - Jin Xiao Lian
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong SAR
| | - Cindy Lo-Kuen Lam
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong SAR, Hong Kong SAR, Hong Kong SAR
| | - Kendrick Co Shih
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 301B Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong SAR.
| | - Jimmy Shiu-Ming Lai
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 301B Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong SAR.
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Sen S, Das M, Das M, Dash S. Challenges in managing glaucoma-related morbidity due to lockdown in a developing country. J Family Med Prim Care 2022; 11:1410-1415. [PMID: 35516718 PMCID: PMC9067215 DOI: 10.4103/jfmpc.jfmpc_1371_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/04/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: The aim of this study was to assess the ocular morbidity due to delayed presentation in glaucoma patients because of COVID lockdown. Methodology: This was a retrospective study of 15 cases presented to us between October 2020 and February 2021. Cause of glaucoma in our study group was either primary angle closure, pseudoexfoliation, lens-induced glaucoma, or neovascular glaucoma. The cause of delayed presentation was identified and patients were treated with antiglaucoma medications, Nd-Yag laser, and surgery as per the standard treatment protocol. Results: With both medical and surgical intervention, some useful vision was restored in five cases while in rest it was not salvageable. The vision in the affected eye ranged from 6/60 in Snellen’s chart to perception of light and projection of rays positive. Better results were achieved in angle, closure, and lens-induced glaucoma cases as compared to neovascular glaucoma cases. Conclusion: The time of presentation in such cases is as important as the etiopathogenesis. We are left with limited treatment options if the presentation is late. The lockdown ended but it unraveled quite a few instances of disease presentation which were totally preventable under normal circumstances. Introspection on finding out newer and proactive methods to reach people suffering from such irreversible but preventable diseases is the need of the day especially when preventable but irreversible diseases like glaucoma are considered.
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Kuo KH, Anjum S, Nguyen B, Marx JL, Roh S, Ramsey DJ. Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System. Clin Ophthalmol 2021; 15:3865-3875. [PMID: 34584400 PMCID: PMC8464359 DOI: 10.2147/opth.s330913] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose We conducted a cross-sectional study to assess the utilization of a tele-ophthalmology screening program in a low-risk, suburban population of patients with diabetes. Methods A total of 214 diabetic patients without previously documented diabetic retinopathy (DR) underwent point-of-care non-mydriatic fundus photography through their primary care providers at five Beth Israel Lahey Health locations. The characteristics of the patients who received remote screening were compared with those patients who were eligible for screening but did not take part in the program. Time-driven activity-based costing (TDABC) was implemented to examine the cost of screening by tele-ophthalmology compared with in-person examinations. Results Tele-ophthalmology screening was more likely to be provided for patients who were younger (OR 0.985; 95% CI 0.973–0.997, p=0.016), who were obese (OR 2.04; 95% CI: 1.47–2.84, p=0.008), who had an HbA1c above 8.0% (OR 1.60; 95% CI: 1.13–2.26, p=0.031), or who had an eye examination in the past year (OR 5.55; 95% CI: 3.89–7.92, p<0.001). Those patients newly diagnosed with DR because of the program were more likely to have diabetic nephropathy (OR 7.79; 95% CI: 1.73–35.05, p=0.007). TDABC identified a health system cost-savings of between $8 and $29 per patient screened by tele-ophthalmology compared with the cost of in-person eye examinations. Conclusion Tele-ophthalmology presents an opportunity to reduce the costs of screening patients without prior evidence of DR, especially those who have completed a comprehensive eye examination within the prior year.
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Affiliation(s)
- Kristen H Kuo
- Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA.,Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA
| | - Sidrah Anjum
- Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA
| | - Brian Nguyen
- Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA.,Tufts University School of Dental Medicine, Boston, MA, USA.,Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Jeffrey L Marx
- Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA.,Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA
| | - Shiyoung Roh
- Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA.,Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA
| | - David J Ramsey
- Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA.,Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA
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Abstract
PURPOSE OF REVIEW Diabetic retinopathy (DR) is one of the leading causes of vision loss worldwide. Although screening and early treatment guidelines for DR have significantly reduced the disease burden, restrictions related to the COVID-19 pandemic have changed real-world practice patterns in the management of DR. This review summarizes evolving guidelines and outcomes of the treatment of DR in the setting of the pandemic. RECENT FINDINGS Intravitreal injections for DR have decreased significantly globally during the pandemic, ranging from approximately 30 to nearly 100% reduction, compared to corresponding timepoints in 2019. Most studies on functional outcomes show a decrease in visual acuity on delayed follow-up. Changing practice patterns in the management of DR has led to fewer intravitreal injections and overall reduction in visual acuity on follow-up. As COVID variants emerge, it will be necessary to continue evaluating practice guidelines.
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Affiliation(s)
- Ishrat Ahmed
- grid.21107.350000 0001 2171 9311Wilmer Eye Institute, Johns Hopkins University, 600 N. Wolfe Street, Maumenee 726, Baltimore, MD 21287 USA
| | - T. Y. Alvin Liu
- grid.21107.350000 0001 2171 9311Wilmer Eye Institute, Johns Hopkins University, 600 N. Wolfe Street, Maumenee 726, Baltimore, MD 21287 USA
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Soleimani M, Mehrpour M, Mohammad-Rabei H. Ophthalmic practice during COVID-19 pandemic. Int J Ophthalmol 2021; 14:639-642. [PMID: 34012876 DOI: 10.18240/ijo.2021.05.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/11/2021] [Indexed: 11/23/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) pandemic has caused significant changes in ophthalmic practice. The initial strategy of strict restriction of elective activities has been replaced with various guidelines to revitalize ophthalmic procedures considering the new safety concerns. In this manuscript, we reviewed recent recommendations for ophthalmic practice in different fields of ophthalmology during the COVID-19 pandemic.
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Affiliation(s)
- Mohammad Soleimani
- Ocular Trauma and Emergency Department, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mohammad Mehrpour
- Ocular Trauma and Emergency Department, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
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