ABSTRACT
Purpose : During the COVID-19 pandemic lockdown, ophthalmology injection clinic volume at the Veteran Affairs (VA) Greater Los Angeles decreased by 50% and it rebounded back to pre-COVID clinic volumes immediately after. The COVID-19 vaccines were introduced for individuals 16 years and older under emergency use authorization by the FDA in December of 2020. The focus of this study is to examine non-ophthalmic characteristics of patients in intravitreal injection clinic during the COVID-19 vaccine era. Methods : Retrospective chart review study of patients who received intravitreal injections during 7-week period in 2021 (COVID-19 vaccine era) was compared to 2019 (baseline pre-pandemic), and 2020 (peak COVID-19). Electronic medical records were used to obtain patients' demographics, ophthalmic conditions, non-ophthalmic conditions, and COVID-19 vaccine records. Results : During the 7-week period in 2021, 88.5 % of patients receiving intravitreal injections were vaccinated (n= 263). Of the vaccinated patients, 83.6% received the Pfizer vaccine, 3.8% Moderna, and 1.1% J&J. Of those receiving either the Pfizer or Moderna vaccine, 1.7% were partially vaccinated while all others were fully vaccinated. Patients with a higher BMI were more likely to follow up after vaccination compared to baseline (p=0.019). Hispanic patients were more likely to follow up after vaccination compared to peak COVID-19 period (p=0.026). Cancer patients were more likely to follow up following vaccine compared to baseline (p=0.0001), but no difference compared to peak COVID-19 period. Transplant patients were more likely to follow up following vaccination compared to peak COVID-19 period (p=0.0001), but no difference compared to baseline (p=0.656). Patients with COPD were less likely to follow up even with vaccine (p=0.0001). Conclusions : The availability of the COVID-19 vaccines impacted intravitreal injection follow up at the VA Los Angeles ophthalmology injection clinic. Most patients receiving intravitreal injection clinic were fully vaccinated. Immunocompromised patients and those with higher BMI were more likely to follow up after the availability of COVID-19 vaccination. Patients with COPD were less likely to follow up even with the availability of vaccines.
ABSTRACT
Purpose : In 2019, a novel teleretinal imaging program was implemented at the Veteran Affairs (VA) Greater Los Angeles Healthcare System providing remote OCT evaluation with prompt retinal specialist evaluation. The purpose of this study was to determine how the COVID-19 pandemic affected the tele-OCT screening program in its second year of implementation. Methods : Retrospective chart review study of patients evaluated by a retina specialist through asynchronous tele-OCT evaluation in 2019 and 2020. Electronic medical records were used to obtain patients' demographic and clinical characteristics, tele-OCT consult results, and patient adherence to tele-OCT follow-up plans. Results : There were 108 tele-OCT consults in 2020 compared to 158 tele-OCT consults in 2019, a 32% decrease. There was no significant difference in overall patient adherence to follow-up between the two years. In 2020, patients who had diagnosed anxiety were less likely to be adherent compared to 2019 (37.5% v. 71.4%, p=0.023). In 2020, the retinal diagnosis was less likely to be changed after teleretinal consultation compared to 2019 (12.96% v. 29.1%, p<0.01). Conclusions : The decrease in tele-OCT use reflects the decrease in patients presenting to referring clinics that utilized the consult mechanism during the COVID-19 pandemic. Patient anxiety should be considered when addressing compliance. The teleretinal program is providing an education benefit to referring providers.