Current safety preferences for intravitreal injection during COVID-19 pandemic

Shmueli, Or; Chowers, Itay; Levy, Jaime

doi:10.1038/s41433-020-0925-x

Cited by 29 publications

(48 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We describe our clinical experience with administering intravitreal injections during the COVID-19 lockdown under strict adherence to infection transmission protocols. These precautions, which are consistent with recent internationally recommended retina practice guidelines and similar clinical experiences with IVI therapy from specialized retina clinics, [7][8][9] were successfully followed by our medical staff and patients with no reported incidents. Under such circumstances, it is important to maintain frequent verbal and written communication with the patient and clear instructions regarding logistic and infection control arrangements.…”

Section: Discussionsupporting

confidence: 63%

“…Several recommendations and guidelines for ophthalmic practice during the COVID-19 era, including intravitreal injections (IVI), have been recently introduced by international expert committees and ophthalmology teams who had first-hand COVID-19 experience. [4][5][6][7][8][9][10] Following such protective measures may be particularly relevant in ophthalmic practice due to the increased risk for transmission of respiratory-borne pathogens, including the COVID-19 virus, with the close proximity that is often required between patients and caregivers. 11 Risk assessment and triage, postponement of non-urgent cases, hygienic practices and protective equipment as well as teleophthalmology virtualized services, have been proposed or implemented.…”

Section: Introductionmentioning

confidence: 99%

“…6 However, suspending vital ophthalmic services, as in IVI, may result in significant or irreversible vision loss in some patients. 8 Due to the accumulating need for IVI therapy after the lockdown, and with the uncertainty that surrounds the prevention or management of COVID-19 disease, the authors took the initiative to provide IVI therapy for priority patients during the lockdown. We aim to describe our clinical experience with IVI therapy at a tertiary university hospital during the COVID-19 lockdown.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Experience in the Administration of Intravitreal Injection Therapy at a Tertiary University Hospital in Jordan During the COVID-19 Lockdown

Saleh¹,

Jammal²,

Alqudah³

et al. 2020

OPTH

View full text Add to dashboard Cite

Purpose: To describe the clinical experience with the delivery of intravitreal injection therapy to patients with various indications at a tertiary university hospital during the COVID-19 lockdown in Jordan. Methods: This is a retrospective observational study of patients who received intravitreal injections between April 12th and May 9th, 2020, a period during the national COVID-19 lockdown (March 16th to June 6th, 2020). Special medical and logistic arrangements, priority and visual risk assessment and strict infection control precautions were implemented. Demographics, diagnosis, intravitreal injection history, medical history, ophthalmic examinations and optical coherence tomography data were collected and analyzed. Results: Intravitreal injections were successfully administered to 132 patients with diabetic retinopathy, age-related macular degeneration and retinal vein occlusion. All logistic and transmission control measures were followed by the medical staff and patients with no incidents. No new exposures or COVID-19 positive cases were traced to our location or time of therapy. No complications related to the injections were recorded. The mean period of delay due to the lockdown from the original scheduled appointment was six weeks. Mean visual acuity significantly decreased from 20/55 before the lockdown to 20/70 after the lockdown, and mean central macular thickness significantly increased from 329 to 370 μ. Conclusion: The administration of intravitreal injection therapy during the COVID-19 lockdown under special safety precautions was feasible and successful. Resumption of the essential therapies and medical services during periods of pandemic restrictions while adhering to strict transmission control measures is encouraged.

show abstract

Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Experience in the Administration of Intravitreal Injection Therapy at a Tertiary University Hospital in Jordan During the COVID-19 Lockdown

Saleh¹,

Jammal²,

Alqudah³

et al. 2020

OPTH

View full text Add to dashboard Cite

show abstract

“…This disease has hit several regions worldwide and single countries' outbreaks have evolved at different speeds and at distinct times. During the worst phases of COVID-19 outbreak, in order to reduce the chance of transmitting the virus to either patients or healthcare personnel, providers have deferred elective and preventive visits, and outpatient visits have been restricted to more urgent care [19][20][21][22][23]. Symmetrically, many patients have also postponed visits in order to avoid being exposed.…”

Section: Introductionmentioning

confidence: 99%

Short-term outcomes of patients with neovascular exudative AMD: the effect of COVID-19 pandemic

Borrelli

Grosso

Vella

et al. 2020

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Purpose To estimate the impact of delayed care during the coronavirus disease 2019 (COVID-19) pandemic on the outcomes of patients with neovascular age-related macular degeneration (AMD). Methods Consecutive patients with diagnosis of neovascular AMD were consecutively enrolled between March 9, 2020, and June 12, 2020, (during and immediately after the Italian COVID-19 quarantine). During the inclusion (or pandemic) visit (V 0), patients received a complete ophthalmologic evaluation, including optical coherence tomography (OCT). Best-corrected visual acuity (BCVA) and OCT findings from the two preceding visits (V −1 and V −2) were compared with data at V 0. Results One-hundred patients (112 eyes) were enrolled in this study. The time interval between following visits was 110.7 ± 37.5 days within V 0 and V −1 and 80.8 ± 39.7 days within V −1 and V −2 , respectively (P < 0.0001). BCVA was statistically worse at the V 0 visit as compared with the immediately preceding (V −1) visit (0.50 ± 0.43 LogMAR and 0.45 ± 0.38 LogMAR at the V 0 and V −1 visits, respectively; P = 0.046). On structural OCT, 91 out of 112 (81.2%) neovascular AMD eyes displayed the evidence of exudative disease activity at the V 0 visit, while 77 (68.7%) eyes exhibited signs of exudation at the V −1 visit (P = 0.022). No differences in terms of BCVA and OCT findings were detected between the V −1 and V −2 visits. In multiple regression analysis, the difference in BCVA between V 0 and V −1 visits was significantly associated with the interval time within these two visits (P = 0.026). Conclusion The COVID-19 pandemic-related postponement in patient care proved to be significantly associated with worse short-term outcomes in these patients. Keywords COVID-19. Retina. Neovascular AMD. Outcome This is part of a topical collection on Perspectives on COVID-19

show abstract

“…15 On the other hand, withholding IVI can cause irreversible vision loss in some patients. 16,17 Through a unique set of circumstances, on March 18th 2020, one of our retina fellows was diagnosed with COVID-19 and hospitalized. This caused three (two vitreoretinal surgeons (VRs) and one medical retina specialist) out of five of our retina specialists in addition to the only two retina fellows to be placed into a 14-day quarantine.…”

Section: Introductionmentioning

confidence: 99%

Hybrid Telehealth Medical Retina Clinic Due to Provider Exposure and Quarantine During COVID-19 Pandemic

Aweidah¹,

Safadi²,

Jotkowitz³

et al. 2020

OPTH

Self Cite

View full text Add to dashboard Cite

To present our hybrid telehealth medical retina clinic service with intravitreal injections (IVI) treatment as a safe alternative to in-person visits and examination during COVID-19 pandemic disease. Methods: Due to exposure to a COVID-19 positive retina fellow, our retina service, in quarantine, evaluated patients' medical files and retinal scans using a telemedicine approach. A different protocol for patients coming for IVI during the COVID-19 pandemic was established for IVI administration. Results: During the 14-day quarantine period (between March 18th and March 31st 2020), the hybrid telehealth medical retina clinic performed 523 IVI to 394 patients with a mean age ± SD 70.96 ± 14.4 years. IVI were administered for neovascular age-related macular degeneration in 50.5% of the cases (199 patients), diabetic macular edema in 21.3% (84 patients), retinal vein occlusion in 17.5% (69 patients), and 10.7% for other retinal pathologies (42 patients). No ocular or systemic complications were observed. Conclusion: During disasters and pandemics, IVI can be provided safely using a hybrid telehealth medical retina clinic approach but only in the appropriate patient and health care system.

show abstract

Current safety preferences for intravitreal injection during COVID-19 pandemic

Cited by 29 publications

References 12 publications

<p>Clinical Experience in the Administration of Intravitreal Injection Therapy at a Tertiary University Hospital in Jordan During the COVID-19 Lockdown</p>

<p>Clinical Experience in the Administration of Intravitreal Injection Therapy at a Tertiary University Hospital in Jordan During the COVID-19 Lockdown</p>

Short-term outcomes of patients with neovascular exudative AMD: the effect of COVID-19 pandemic

<p>Hybrid Telehealth Medical Retina Clinic Due to Provider Exposure and Quarantine During COVID-19 Pandemic</p>

Contact Info

Product

Resources

About