Table 3.
Summary of changes to logistics and procedural practices of intravitreal injection therapy (IVT) during the COVID-19 pandemic time
| Country (city/region) | Prior to intravitreal injections being administered | Intravitreal Injection procedure | |||||
|---|---|---|---|---|---|---|---|
| Screening for high risk COVID patients performed (temperature screen, symptoms, travel history) | High-risk COVID patients allowed to the specialist outpatient clinic for IVT | Changes to performing OCT imaging | Changes to performing ophthalmology consult | Changes to the setting where the majority of IVTs was performed | Changes to the skilled manpower used to administer IVT | Changes to the IVT administration procedure or equipment | |
| Asia- Pacific | |||||||
| China(Guangzhou) | Yes | No | No | No | Yes, reduced numbers, social distancing, reduced follow up appointments | No | No |
| Israel(Tel Aviv) | Yes | No, deferred for 2 weeks | Yes, reduced OCT performed | Yes, reduced VA, slit-lamp exam | Yes, Reduced numbers and social distancingAn additional injection clinic opened outside the hospitalHome injections in selected cases | No | Yes, face shield and gown worn. N95 mask was available at physician’s discretion |
| Malaysia (Kuala Lumpur) | Yes | No, deferred | No | No | Yes, reduced numbers, social distancing, reduced follow up appointments | No | Yes, face shield was worn |
| Singapore | Yes | No, deferred | Yes, reduced OCT performed | Yes, reduced VA, slit-lamp exam | Yes, reduced numbers, reduced time in clinic, social distancing | No | Yes, goggles of face-shield recommended |
| Thailand (Bangkok) | Yes | Yes, if no fever detected | No | No | Yes, IVT clinic/OT stopped only IVT in the treatment room | No | No |
| Europe | |||||||
| France(Paris) | Yes | Yes | Yes, reduced OCT performed (no OCT in patients with known interval) | Yes, no slit lamp exam in patients with known interval | Yes, reduced numbers, reduced time in clinic, social distancing | No | No |
| Germany (Berlin) | Not formally | Yes, obviously sick patients asked to return later | No | Yes, telephone consults for patients instead of routine follow up examination | Yes, reduced numbers | No | No |
| Germany(Munich) | Yes | Yes, high risk cases screened in isolation | No | Yes, only VA, IOP, OCT taken no slit lamp exam | Yes, reduced numbers | No | No |
| Greece(Athens) | Yes | No | Yes, reduced OCT performed | Yes, reduced VA and slit-lamp exam | Yes, reduced numbers, social distancing | No | No |
| Italy(Rome) | Yes | No, deferred for 2 weeks | No | No | Yes, reduced numbers, social distancing | No | Yes, face shields worn by all staff |
| Italy(Milan) | Yes | Yes, high risk cases screened in isolation | No | Yes, telephone consults for symptoms screening | Yes, no injections in OT all IVT done in small procedures room | Yes, more senior ophthalmologists performing IVT as junior staff are deployed elsewhere | Yes, face shields worn by all staff |
| Switzerland (Lucerne) | No | Yes | Yes, reduced OCT, done only in treatment naïve patients and those patients with significant vision loss | Yes, no routine VA, IOP and slit lamp examination telephone consults done | Yes, reduced numbers, waiting time, social distancing | No | No |
| United Kingdom(London) | Yes | No, deferred for 2 weeks | Yes, reduced OCT performed | Yes, no routine VA, IOP or slit lamp exam performed | Yes, reduced numbers, waiting time, social distancing | No | No |
| United Kingdom (Wales) | Yes (department dependent) | No, deferred for 2 weeks | Yes, reduced OCT performed | Yes, no routine VA, IOP or slit lamp exam performed, virtual consults continue | Yes, reduced numbers, waiting time, social distancing | No | Yes, surgical mask strongly recommended |
| North and South America | |||||||
| Brazil(Recife) | Yes | No | No | Yes, included virtual consultations | Yes, reduced numbers, waiting time, social distancing | No | No |
| Canada(Vancouver) | No | Yes | No | Yes, DME and RVO patients contacted by telephone | No | No | Yes, gloves, goggles and masks for all staff, masks for any sick patients |
| Colombia(Cali) | Yes | No | Yes, reduced OCT performed | Yes, no pinhole or IOP, virtual consults where possible | No | No | Yes, face shield and gown worn. N95 mask was available at physician’s discretion |
| United States of America (Chicago) | Yes | Yes, high risk cases screened in isolation | Yes, only basic OCT allowed | No | Yes, reduced numbers, waiting time, social distancing | No | Yes |
VA: visual acuity, IOP: intraocular pressure, OCT: optical coherence tomography, DME: diabetic macula edema, RVO: retinal vein occlusions