RESUMEN
Antecedentes: La pérdida de visión tiene consecuencias tanto en la salud como en la estabilidad económica, ya que promueve retrasos en el desarrollo emocional, social, además de reducciones en la productividad laboral. Objetivo: Estimar la carga económica de la degeneración macular asociada a la edad neovascular (DMAEn) y el edema macular diabético (EMD) en Colombia para el año 2022. Método: Para una perspectiva social se incluyeron costos directos utilizando la aproximación de Bottom-up y costos indirectos relacionados con la pérdida de productividad. Resultados: El costo directo de un paciente con DMAEn fue 5.974 USD$ desde una base teórica. A nivel nacional, la DMAEn costaría 179,9 millones USD$. Los costos indirectos de DMAEn se estimaron en 13,9 millones USD$. Los costos directos teóricos en EMD fueron 741,6 millones USD$. El costo nacional sería de 132,04 millones USD$. Para los costos indirectos de EMD, se estimó un costo de 93,3 millones USD$. Conclusiones: La DMAEn y el EMD tienen un alto impacto para el sistema de salud y la sociedad.
Background: The vision loss has consequences for both health and economic stability, since it promotes delays in emotional and social development, as well as reductions in labor productivity. Objective: To estimate the economic burden of age-related macular degeneration (AMD) and diabetic macular edema (DME) in Colombia for 2022. Method: For a social perspective, direct costs were included using the bottom-up approach, and indirect costs related to lost productivity. Results: The direct costs of treating a patient with AMD were USD $5,974 from a theoretical background. At national level, the AMD would cost USD $179.9 million. The AMD indirect cost in Colombia was estimated in USD $13.9 million. Patients theoretical direct cost of DME was USD $741.6 million. The cost at national level is USD $132.04 million. Regarding the indirect costs result for DME, a cost of USD $93.31 million was estimated. Conclusions: The AMD and the DME have a considerable impact on the health system and society.
Asunto(s)
Humanos , Colombia , Diabetes MellitusRESUMEN
ABSTRACT To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.
RESUMO Identificar e classificar as informações disponíveis sobre o COVID-19 e o tratamento oftalmológico de acordo com o nível de evidência, dentro de quatro tópicos principais de interesse: evidência do vírus nas lágrimas e na superfície ocular, infecção pela via conjuntival, manifestações oculares e recomendações de melhores práticas. Foi realizada uma revisão estruturada no PubMed, ScienceDirect, LILACS, SciELO, Biblioteca Cochrane e Google Scholar no COVID-19 e oftalmologia. A planilha de Níveis de Evidência 2011 do Oxford Centre for Evidence Based Medicine 2011 foi usada para avaliações de qualidade. Mil e dezoito itens foram identificados na busca; Foram incluídos 26 registros na síntese qualitativa, que incluiu 6 revisões de literatura, 10 séries de casos ou estudos transversais, 4 relatos de casos e 6 descrições de intervenções. Dezessete dos 26 registros (65%) foram classificados como nível 5 no sistema de classificação da metodologia Oxford CBME, o restante foi no nível 4. As evidências geradas no COVID-19 e na oftalmologia até o momento são limitadas, embora isso seja compreensível dadas as circunstâncias. Tanto a possível presença de partículas virais em lágrimas e conjuntiva quanto o potencial de transmissão conjuntival permanecem controversos. As manifestações oculares não são frequentes e podem se assemelhar a infecção viral da superfície ocular. A maioria das recomendações baseia-se nas estratégias implementadas pelos países asiáticos durante surtos anteriores de coronavírus. Há necessidade de estudos aprofundados avaliando essas estratégias no cenário da SARS-CoV-2. Enquanto isso, os planos para a aplicação dessas medidas devem ser implementados com cautela, levando em consideração o contexto de cada país e submetidos a auditorias periódicas.