Optical coherence tomography angiography analysis of changes in the foveal avascular zone in eyes with diabetic macular edema treated with intravitreal anti-vascular endothelial growth factor.

BACKGROUND: To analyze the changes in foveal avascular zone (FAZ) area, perimeter, and circularity in the superficial (SCP) and deep (DCP) capillary plexuses in eyes with diabetic macular edema (DME) treated with intravitreal anti-VEGF using optical coherence tomography angiography (OCTA). METHODS: This prospective observational study included 56 eyes from 32 patients with DME that received intravitreal anti-VEGF. OCTA images were obtained at baseline and 1, 3, and 6 months of follow-up. The outcome measures were FAZ area, perimeter, and circularity in both the SCP and DCP, as well as central subfield thickness (CST) and best-corrected visual acuity (BCVA). RESULTS: The mean number of intravitreal anti-VEGF injections received during the observation period was 4.60 ± 0.82 (range: 3-6). The FAZ area, perimeter, and circularity were statistically unchanged at all observation points in both the SCP (p = 0.772, p = 0.405, p = 0.157, respectively) and the DCP (p = 0.620, p = 0.769, p = 0.481, respectively). Despite having no change in the FAZ parameters, there was still a statistically significant decrease in CST (p < 0.001) as well as a statistically significant increase in BCVA (p = 0.004) during the observation period. CONCLUSIONS: The FAZ area, perimeter, and circularity in the SCP and DCP as measured by OCTA remained stable during the first 6 months of intravitreal anti-VEGF therapy in eyes with DME. While there were no significant changes in the FAZ, treatment with intravitreal anti-VEGF still resulted in decreased CST and improved BCVA.

Changes in Retina Practice Patterns During the COVID-19 Pandemic in the Philippines.

PURPOSE: The aim of this study was to assess the changes in clinical practice patterns among retina specialists in the Philippines in response to the coronavirus disease 2019 (COVID-19) pandemic. MATERIALS AND METHODS: This was a multi-center cross-sectional study based on a self-reported online survey. An online questionnaire was distributed among practicing retina specialists in the Philippines as listed in the database of the Vitreo-Retina Society of the Philippines using a combination of convenience and snowball sampling. The questionnaire contained questions regarding changes in clinic set-up, laser procedures, intravitreal injections, vitreoretinal surgery, and long-term outlooks. RESULTS: A total of 48 responses were recorded and analyzed with a view rate of 41.7%. There was a decrease in the number of clinic consults, laser procedures, intravitreal injections, and vitreoretinal procedures with most reporting only 1-25% of their usual patient load. Several modifications in clinic protocols have been made, including use of personal protective equipment, adjustments in clinic hours, and scheduling of only urgent cases. The adjustments implemented during the pandemic are expected by most respondents to be long-term changes. CONCLUSION: Retina specialists in the Philippines have implemented changes in their practices to combat COVID-19, following guidelines issued by the local and international governing bodies on health.