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Tan ACS, Schwartz R, Anaya D, Chatziralli I, Yuan M, Cicinelli MV, Faes L, Mustapha M, Phasukkijwatana N, Pohlmann D, Reynolds R, Rosenblatt A, Savastano A, Touhami S, Vaezi K, Ventura CV, Vogt D, Ambati J, de Smet MD, Loewenstein A. Are intravitreal injections essential during the COVID-19 pandemic? Global preferred practice patterns and practical recommendations. Int J Retina Vitreous 2022; 8:33. [PMID: 35672810 PMCID: PMC9171474 DOI: 10.1186/s40942-022-00380-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/01/2022] [Indexed: 11/12/2022] Open
Abstract
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.
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Affiliation(s)
- A C S Tan
- Singapore National Eye Centre, Singapore, Singapore. .,Singapore Eye Research Institute, Singapore, Singapore. .,Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
| | - R Schwartz
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - D Anaya
- Department of Retina, Clínica de Oftalmología de Cali, Valle del Cauca, Colombia
| | - I Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - M Yuan
- Department of Retina, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M V Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Faes
- Moorfields Eye Hospital NHS Foundation Trust, London, UK.,Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - M Mustapha
- Department of Ophthalmology, Universiti Kebangsaan Malaysia, Kulala Lumpur, Malaysia
| | - N Phasukkijwatana
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - D Pohlmann
- Charité - Universitätsmedizin Berlin, FreieUiversität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - R Reynolds
- Department of Ophthalmology, Aneurin Bevan University Health Board, Wales, UK
| | - A Rosenblatt
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - A Savastano
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Touhami
- Department of Ophthalmology, Reference Center in Rare diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - K Vaezi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - C V Ventura
- Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, Brazil.,Department of Ophthalmology, HOPE Eye Hospital, Recife, Brazil
| | - D Vogt
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - J Ambati
- Center for Advanced Vision Science, Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, USA
| | - M D de Smet
- Department of Ophthalmology, Leiden University, Leiden, The Netherlands.,MIOS sa, Lausanne, Switzerland
| | - A Loewenstein
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Chatziralli I, Ventura CV, Touhami S, Reynolds R, Nassisi M, Weinberg T, Pakzad-Vaezi K, Anaya D, Mustapha M, Plant A, Yuan M, Loewenstein A. Transforming ophthalmic education into virtual learning during COVID-19 pandemic: a global perspective. Eye (Lond) 2021; 35:1459-1466. [PMID: 32651545 PMCID: PMC7348577 DOI: 10.1038/s41433-020-1080-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has imposed measures of social distancing and barriers in delivery of "in person" education. Institutions, involved in training the next generation of ophthalmologists, are using alternative teaching methods to maintain the standard of education. METHODS We conducted a worldwide survey among physicians, who are actively involved in Ophthalmology-related education, between 3 and 14 April 2020. The expert survey, developed on the basis of literature search and focus group discussions, comprised 23 questions addressing the use of e-learning in Ophthalmology during the COVID-19 pandemic. RESULTS A total of 321 participants from both academic and non-academic institutions worldwide, with variable practice experience and expertise, completed the survey. Before the pandemic, the majority of participants used traditional training modalities, including lectures, grand rounds and journal clubs, and 48% did not use any e-learning. There was a statistically significant increase in the use of all e-learning alternatives during the pandemic (p < 0.001), associated mainly with the availability of e-learning facilities (p < 0.001) and the academic character of institutions (p < 0.001). Zoom® was recognized as the mostly used platform for virtual teaching. Although theoretical teaching may take place, the surgical training of residents/fellows was dramatically reduced. The latter was significantly associated with participants' perspectives about teaching practices (p < 0.001). CONCLUSION COVID-19 pandemic imposed great challenges in the educational field of Ophthalmology. The experience related to virtual training in Ophthalmology, gained during the pandemic, may change the traditional teaching practices in the world and provide new educational opportunities.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece.
| | - Camila V Ventura
- Department of Ophthalmology, Altino Ventura Foundation, Recife, Brazil
- Department of Ophthalmology, HOPE Eye Hospital, Recife, Brazil
| | - Sara Touhami
- Department of Ophthalmology, Reference Center in Rare diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Rhianon Reynolds
- Department of Ophthalmology, Aneurin Bevan University Health Board, Wales, UK
| | - Marco Nassisi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Tamir Weinberg
- Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel
- Hadassah School of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Kaivon Pakzad-Vaezi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Denis Anaya
- Department of Retina and Vitreous, Clínica de Oftalmología de Cali, Cali, Colombia
| | - Mushawiahti Mustapha
- Department of Ophthalmology, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Adam Plant
- Westmead and Central (Save Sight Institute) Clinical Schools, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, NSW, Australia
| | - Miner Yuan
- State Key Laboratory of Ophthalmology, Retina Division, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Anat Loewenstein
- Division of Ophthalmology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Mohammadi H, Abuodeh Y, Jin W, Frakes J, Friedman M, Biebel B, Choi J, El-Haddad G, Kis B, Sweeney J, Kim R, Pimiento J, Malafa M, Anaya D, Hoffe S. Using the ALBI Grade as a Prognostic Marker for Radioembolization of Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ioannides P, Abuodeh Y, Jin W, Hoffe S, Frakes J, Kim R, Choi J, El-Hadda G, Biebel B, Kis B, Sweeney J, Friedman M, Kothari N, Anaya D, Latifi K. Impact of Sarcopenia Evaluated Using the Total Psoas Area (TPA) in Patient Undergoing Y-90 Radioembolization for Hepatocellular Carcinoma (HCC). Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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