Prioritising of Retinal Diseases During Covid-19 Outbreak

Abstract

Purpose: The aim of this study was to determine a management strategy for patients with retinal diseases to minimise the potential risk of visual impairment due to the postponement of treatments and visits during the lockdown for COVID-19. Methods: Records of all patients who had rescheduled for retina appointments from March 20, 2020, to June 1, 2020, were identified to evaluate the details regarding best-corrected visual acuity (BCVA) before the COVID-19 pandemic (V0 visit) and at the first visit after lockdown (V1 visit); primary diagnosis, duration of postponement (weeks), change in Snellen line and intravitreal injection (IVI) requirement were recorded. Patients were rescheduled according to our diagnosis-based triage practice pattern; emergency, Group 1; urgent, Group 2; routine, Group 3; and elective, Group 4. BCVA, loss of Snellen line, IVI requirement, and duration of postponement were compared between V0 and V1 visits. In addition, BCVA, change in Snellen line, and the relationship between loss in Snellen line and duration of postponement was evaluated in intravitreally injected patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). Results: A total of 1,383 eyes of 763 patients were recruited in this study. The difference in BCVA at V0 visit was statistically significant among the groups and better in Group 4 (p<0.000). BCVA at V1 visit was worse in group 1 and statistically different between groups (p<0.001). BCVA was also worse at V1 visit than V0 visit in groups 1 and 2 (p<0.001 and p=0.003). Patients with nAMD had more loss in Snellen line than patients with DME in Group 1 who were injected intravitreally (p=0.004). Conclusion: These results can support retina specialists in anticipating the possible clinical consequences of outbreaks on retina patients and developing successful management strategies.

Keywords

• COVID-19
• coronavirus outbreak
• prioritising
• retinal diseases

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