The outbreak of COVID-19 was followed by a rapid spread leading to its declaration as a pandemic in a short time. The transmission through aerosols and direct contact with infected individuals forced the application of strict safety protocols and rearrangements in the activities of different healthcare systems around the world. Ophthalmology healthcare workers are highly exposed to viral infection and therefore adjustments were made to ensure the safety of patients and health providers by performing only urgent treatments. The suspension and delay in regular follow-up visits and the lower number of patients recorded during the lockdown period due to restrictions and patient anxiety led to severe consequences in the clinical and anatomical outcome affecting the overall prognosis. The current review aims to summarize the effect of the lockdown policies in the number and profile of patients that attended the ophthalmology clinics from different countries and analyze the effect of the pandemic in terms of vision and patient functionality. The effects of the pandemic included a reduction in the number of appointments, cancellations of non-emergency conditions and delays of surgical interventions. These had a negative effect in terms of visual outcomes.

Purpose: To determine the prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort of Greek diabetic patients and identify possible risk factors. Methods: Population-based, non-interventional, cross-sectional study of 300 diabetic Greek patients attending the medical retina clinics of a tertiary hospital. Clinical and imaging data were recorded and statistical analysis was performed. Con dence intervals (CI) at 95% and statistically signi cant p values ≤0.05 were set.Results: A total of 300 diabetic patients were included. Of these patients, 21 (7%) were diagnosed with diabetes mellitus (DM) type I and 279 (93%) with DM type II. The average duration of diabetes was 15 ± 9.4 years (95% CI, 13.9-16.1) and the mean level of HbA1c was 7.2 ± 1.3 (95% CI, 7.1-7.4) overall. Prevalence of DR was 38.7% (116 patients), only 15 patients (5%) had proliferative DR and diabetic macular edema (DME) was detected in 19 patients (6.3%). In DM type I patients, 52.4% had DR and 9.5% had DME, while in the DM type II group, 37.6% had DR and 6.1% had DME. Binary logistic regression analysis identi ed duration of diabetes, increased HbA1c and hypertriglyceridemia as potential risk factors.Conclusions: This study is the rst one to present the extent and severity of DR and DME in a Greek cohort of diabetic patients and also identify risk factors associated with these entities. Our ndings highlight the signi cance of a properly organized national screening program for the early detection and management of the vision threatening complications of DR.

Purpose: To assess fibrovascular pigment epithelial detachments (PED) and their response to two different anti-VEGF agents using optical coherence tomography (OCT) morphometric analysis. Methods: Seventy-three consecutive, treatment-naïve eyes with fibrovascular PED (>125 μm) treated with ranibizumab or aflibercept were retrospectively included. A custom-made software was used to manually segment and calculate PED maximum height, base area, volume and internal reflectivity at baseline, after three injections and 1 year. Results: Visual acuity (VA) change was 2 ETDRS letters ± 7.6 after three injections and 3.2 ETDRS letters ± 10.3 at 1 year. There was no significant difference between VA changes amongst the two drugs. At 1 year, anti-VEGF treatment resulted in a mean reduction of 125 μm in maximum PED height, of 2.26 mm2 in base area and of 0.54 mm3 in volume with a corresponding increase in reflectivity. These changes were more prominent in the aflilbercept group. The observed PED and VA changes at year 1 were strongly correlated with their values at baseline and after three injections. Conclusions: Anti-VEGF treatment resulted in a reduction of all PED dimensions and a corresponding increase in optical reflectivity. Higher, larger and more hypo-reflective PEDs demonstrated a better anatomical response, especially with aflibercept, but this was not correlated with VA.

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Purpose: To determine the prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort of Greek diabetic patients and identify possible risk factors. Methods: Population-based, non-interventional, cross-sectional study of 300 diabetic Greek patients attending the medical retina clinics of a tertiary hospital. Clinical and imaging data were recorded and statistical analysis was performed. Confidence intervals (CI) at 95% and statistically significant p values ≤0.05 were set.Results: A total of 300 diabetic patients were included. Of these patients, 21 (7%) were diagnosed with diabetes mellitus (DM) type I and 279 (93%) with DM type II. The average duration of diabetes was 15 ± 9.4 years (95% CI, 13.9-16.1) and the mean level of HbA1c was 7.2 ± 1.3 (95% CI, 7.1-7.4) overall. Prevalence of DR was 38.7% (116 patients), only 15 patients (5%) had proliferative DR and diabetic macular edema (DME) was detected in 19 patients (6.3%). In DM type I patients, 52.4% had DR and 9.5% had DME, while in the DM type II group, 37.6% had DR and 6.1% had DME. Binary logistic regression analysis identified duration of diabetes, increased HbA1c and hypertriglyceridemia as potential risk factors.Conclusions: This study is the first one to present the extent and severity of DR and DME in a Greek cohort of diabetic patients and also identify risk factors associated with these entities. Our findings highlight the significance of a properly organized national screening program for the early detection and management of the vision threatening complications of DR.