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Modifications of intravitreal injections in response to the COVID-19 pandemic.
Weng, Chang-Chi; Lin, Ting-Yi; Yang, Yi-Ping; Hsiao, Yu-Jer; Lin, Tzu-Wei; Lai, Wei-Yi; Lin, Yi-Ying; Chou, Yu-Bai; Lin, Tai-Chi; Chiou, Shih-Hwa; Hwang, De-Kuang; Chen, Shih-Jen.
  • Weng CC; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Lin TY; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
  • Yang YP; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Hsiao YJ; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
  • Lin TW; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Lai WY; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
  • Lin YY; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Chou YB; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
  • Lin TC; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Chiou SH; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
  • Hwang DK; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Chen SJ; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
J Chin Med Assoc ; 84(9): 827-832, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1320351
ABSTRACT
The Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruption to the normal operation of the healthcare system. On a worldwide scale, hospitals suspended nonurgent surgeries and outpatient visits to downsize clinical loadings to redistribute manpower to counteract the pandemic's impact. So far, there is no evidence-based guideline defining a clear line between urgent and nonurgent indications of intravitreal injections (IVI). Herein, we aimed to summarize IVI algorithm modifications and discuss the patient prioritization according to medical needs in the hostile environment in the COVID crisis. Assessing current literature, we found that neovascular age-related macular degeneration is considered the utmost priority among conditions that require IVI. Other conditions assigned with a high priority include monocular or quasi-monocular patients (only one eye > 20/40), neovascular glaucoma, and new patients with significant vision loss. Although patients with central retinal vein occlusion and proliferative diabetic retinopathy are not advised to delay treatments, we found no consistent evidence that correlated with a worse outcome. Diabetic macular edema and branch retinal vein occlusion patients undertaking treatment delay should be regularly followed up every 2 to 3 months. Serving as the principle of management behind the algorithm modifications, the reduction of both patient visit and IVI therapy counts should be reckoned together with the risk of permanent visual loss and COVID infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Intravitreal Injections / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: J Chin Med Assoc Journal subject: Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Intravitreal Injections / SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: J Chin Med Assoc Journal subject: Medicine Year: 2021 Document Type: Article