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Anti-VEGF intravitreal injections in the era of COVID-19: responding to different levels of epidemic pressure.
Korobelnik, Jean-François; Loewenstein, Anat; Eldem, Bora; Joussen, Antonia M; Koh, Adrian; Lambrou, George N; Lanzetta, Paolo; Li, Xiaoxin; Lövestam-Adrian, Monica; Navarro, Rafael; Okada, Annabelle A; Pearce, Ian; Rodríguez, Francisco J; Wong, David T; Wu, Lihteh.
  • Korobelnik JF; Service d'ophtalmologie, CHU Bordeaux, Bordeaux, France. jean-francois.korobelnik@chu-bordeaux.fr.
  • Loewenstein A; Inserm, Bordeaux Population Health Research Center, team LEHA, Université de Bordeaux, UMR 1219, F-33000, Bordeaux, France. jean-francois.korobelnik@chu-bordeaux.fr.
  • Eldem B; Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Joussen AM; Department of Ophthalmology, Hacettepe University, Ankara, Turkey.
  • Koh A; Charité-University Medicine Berlin, Berlin, Germany.
  • Lambrou GN; Eye and Retina Surgeons, Camden Medical Centre, Singapore, Singapore.
  • Lanzetta P; Global Medical Affairs Ophthalmology, Bayer, Basel, Switzerland.
  • Li X; Department of Medicine-Ophthalmology, University of Udine, Udine, Italy.
  • Lövestam-Adrian M; Department of Ophthalmology, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
  • Navarro R; Istituto Europeo di Microchirurgia Oculare, IEMO, Udine, Italy.
  • Okada AA; Eye Center and Eye Institute, Peking University People's Hospital, Beijing, China.
  • Pearce I; Department of Ophthalmology, Lund University Hospital, Lund, Sweden.
  • Rodríguez FJ; Instituto Microcirugia Ocular, Barcelona, Spain.
  • Wong DT; Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.
  • Wu L; Royal Liverpool University Hospital, Liverpool, UK.
Graefes Arch Clin Exp Ophthalmol ; 259(3): 567-574, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1060218
Semantic information from SemMedBD (by NLM)
1. Retinal Diseases PROCESS_OF Patients
Subject
Retinal Diseases
Predicate
PROCESS_OF
Object
Patients
2. Treatment Protocols USES Vascular Endothelial Growth Factors
Subject
Treatment Protocols
Predicate
USES
Object
Vascular Endothelial Growth Factors
3. Retinal Diseases PROCESS_OF Patients
Subject
Retinal Diseases
Predicate
PROCESS_OF
Object
Patients
4. Treatment Protocols USES Vascular Endothelial Growth Factors
Subject
Treatment Protocols
Predicate
USES
Object
Vascular Endothelial Growth Factors
ABSTRACT

PURPOSE:

Following the first wave of the COVID-19 pandemic in early 2020, the easing of strict measures to reduce its spread has led to a resurgence of cases in many countries at both the national and local level. This article addresses how guidance for ophthalmologists on managing patients with retinal disease receiving intravitreal injections of anti-vascular endothelial growth factor (VEGF) during the pandemic should be adapted to the local epidemic pressure, with more or less stringent measures implemented according to the ebb and flow of the pandemic.

METHODS:

The Vision Academy's membership of international retinal disease experts analyzed guidance for anti-VEGF intravitreal injections during the COVID-19 pandemic and graded the recommendations according to three levels of increasing epidemic pressure. The revised recommendations were discussed, refined, and voted on by the 14-member Vision Academy Steering Committee for consensus.

RESULTS:

Protocols to minimize the exposure of patients and healthcare staff to COVID-19, including use of personal protective equipment, physical distancing, and hygiene measures, should be routinely implemented and intensified according to local infection rates and pressure on the hospital/clinic or healthcare system. In areas with many COVID-19-positive clusters, additional measures including pre-screening of patients, postponement of non-urgent appointments, and simplification of complex intravitreal anti-VEGF regimens should be considered. Treatment prioritization for those at greatest risk of irreversible vision loss should be implemented in areas where COVID-19 cases are increasing exponentially and healthcare resources are strained.

CONCLUSION:

Consistency in monitoring of local infection rates and adjustment of clinical practice accordingly will be required as we move forward through the COVID-19 era. Ophthalmologists must continue to carefully weigh the risk-benefits to minimize the exposure of patients and healthcare staff to COVID-19, ensure that patients receive sight-saving treatment, and avoid the potential long-term impact of prolonged treatment postponement.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Angiogenesis Inhibitors / Vascular Endothelial Growth Factor A / SARS-CoV-2 / COVID-19 Type of study: Clinical Practice Guide Limits: Humans Language: English Journal: Graefes Arch Clin Exp Ophthalmol Year: 2021 Document Type: Article Affiliation country: S00417-021-05097-0

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Angiogenesis Inhibitors / Vascular Endothelial Growth Factor A / SARS-CoV-2 / COVID-19 Type of study: Clinical Practice Guide Limits: Humans Language: English Journal: Graefes Arch Clin Exp Ophthalmol Year: 2021 Document Type: Article Affiliation country: S00417-021-05097-0