Remodelling intravitreal therapy pathways for macular disease during the COVID-19 pandemic and an Austrian national lockdown. Issue 1 (18th September 2020)

• Record Type: Journal Article
• Authors: Huemer, Josef; Hienert, Julius; Hirn, Cornelia; Hackl, Christoph; Radda, Stephan M; Findl, Oliver
• Is Part Of: BMJ open ophthalmology. Volume 5:Issue 1(2020)
• Publication Date: 2020-09-18
• Subjects: degeneration -- macula -- neovascularisation -- retina; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1136/bmjophth-2020-000560
• Languages: English
• ISSNs: 2397-3269

Abstract

Abstract : Objective: To analyse the remodelling and recovery of a relocated intravitreal injection (IVI) service with an adapted treatment regimen in a tertiary referral centre during a nationwide lockdown with initial cancellation of all non-emergency treatments caused by the COVID-19 pandemic. Methods and analysis: For this retrospective observational study at Hanusch Hospital, Vienna, between 16 March 2020 and 5 May 2020, we conducted an analysis of an appointment booking system based on prioritisation incorporating disease class, severity and fellow eye status by evidence-based impact on irreversible structural impairment and survey data from telephone interviews. Recapture time was defined as the time-to-discard the backlog of patients in need for treatment. Non-attendance was stratified as treatment refusal for personal reasons and non-attendance due to lockdown-related restrictions. Results: Of the 1109 patients, 241 (21.7%) were considered as highly urgent, 269 (24.3%) as urgent, 402 (36.2%) as semiurgent and 197 (17.8%) as non-urgent. Recapture time was 15 days for highly urgent patients, 22 days for urgent patients, 43 days for semiurgent patients and 46 days for non-urgent patients. The proportion of patients who refused treatment due to personal reasons was 5.2%, with a mean age of 82.4 years; 29 patients (2.6%) could not attend due to lockdown-related restrictions. Conclusion: By streamlining treatment based on urgency as well as increasing the number of bilateral IVI, recapture time was fast. We could provide a safe treatment environment for healthcare professionals and patients after resetting the injection service outside of the hospital with increased levels of protection.