Clinical utility of pre-transplant ophthalmic consultation for lung transplant recipients: implications in the COVID-19 pandemic era

Nanda, Tavish; Breazzano, Mark P.; Bearelly, Srilaxmi

doi:10.1007/s00417-020-04799-1

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Although it is likely that they had some association with outcomes, the magnitude has not been measured. There is speculation that much of delivered health care could be unnecessary, corroborated in some instances by several studies within ophthalmology . In summary, the frequency of urgent or emergent vitreoretinal procedures substantially decreased in the US during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 97%

“…There is speculation that much of delivered health care could be unnecessary, 32 corroborated in some instances by several studies w ithin ophthalmology. [33][34][35][36] In summary, the frequency of urgent or emergent vitreoretinal procedures substantially decreased in the US during the COVID-19 pandemic. This decrease appears to be independent of other factors, including region, practice type, or state-level stay-at-home orders.…”

Section: Discussionmentioning

confidence: 99%

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Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic

et al. 2021

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(AAO) indicated that urgent or emergent vitreoretinal surgical procedures should continue during the coronavirus disease 2019 (COVID-19) pandemic. Although decreases in the frequency of critical procedures have been reported outside the field of ophthalmology, analyses are limited by volume, geography, and time. OBJECTIVE To evaluate whether the frequency of ophthalmic surgical procedures deemed urgent or emergent by the AAO changed across the United States during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS Vitreoretinal practices from 17 institutions throughout the US participated in this multicenter cross-sectional study. The frequency of 11 billed vitreoretinal Current Procedural Terminology (CPT) codes across respective weeks was obtained from each practice between January 1, 2019, and May 31, 2020. Data were clustered into intravitreal injections (code 67028), lasers and cryotherapy (codes 67141, 67145, and 67228), retinal detachment (RD) repairs (codes 67107, 67108, 67110, and 67113), and other vitrectomies (codes 67036, 67039, and 67040). Institutions were categorized by region (Northeast, Midwest, South, and West Coast), practice setting (academic [tax-exempt] or private [non-tax-exempt]), and date of respective statewide stay-at-home orders. MAIN OUTCOMES AND MEASURES Nationwide changes in the frequency of billing for urgent or emergent vitreoretinal surgical procedures during the COVID-19 pandemic. RESULTS A total of 526 536 CPT codes were ascertained: 483 313 injections, 19 257 lasers or cryotherapy, 14 949 RD repairs, and 9017 other vitrectomies. Relative to 2019, a weekly institutional decrease in injections was observed from March 30 to May 2, 2020, with a maximal 38.6% decrease (from a mean [SD] of 437.8 [436.3] to 273.8 [269.0] injections) from April 6 to 12, 2020 (95% CI, −259 to −69 injections; P = .002). A weekly decrease was also identified that spanned a longer interval, at least until study conclusion (March 16 to May 31, 2020), for lasers and cryotherapy, with a maximal 79.6% decrease (from a mean [SD] of 6.6 [7.7] to 1.5 [2.0] procedures) from April 6 to 12, 2020 (95% CI, −6.8 to −3.3 procedures; P < .001), for RD repairs, with a maximal 59.4% decrease (from a mean [SD] of 3.5 [4.0] to 1.6 [2.2] repairs) from April 13 to 19, 2020 (95% CI, −2.7 to −1.4 repairs; P < .001), and for other vitrectomies, with a maximal 84.3% decrease (from a mean [SD] of 3.0 [3.1] to 0.4 [0.8] other vitrectomies) from April 6 to 12, 2020 (95% CI, −3.3 to −1.8 other vitrectomies; P < .001). No differences were identified by region, setting, or state-level stay-at-home order adjustment. CONCLUSIONS AND RELEVANCE Although the AAO endorsed the continued performance of urgent or emergent vitreoretinal surgical procedures, the frequency of such procedures throughout the country experienced a substantial decrease that may persist after the COVID-19 pandemic's initial exponential growth phase. This decrease appears independent of region, setting, and state-level stay-at-home orders. It is unknown to what ex...

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic

et al. 2021

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“…13 These findings recently were replicated. 14 Experience with this pandemic is likely to spur future data-driven studies on the usefulness of ophthalmologic screening for these conditions, or at the very least, a closer inspection of existing data in a systematic fashion. As suggested previously by Oh et al 2 before the COVID-19 pandemic, physicians first must determine nonessential versus essential screening consultation and consider providing a list of nonessential items for consulting services to assist in appropriate triage and resource allocation.…”

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confidence: 99%

A Measured Approach to Inpatient Ophthalmologic Screening in the COVID-19 Era: A Multicenter Perspective

Nanda¹,

Bond

Chen³

et al. 2021

Ophthalmology

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Eye disease in kidney transplantation: Clinical challenges in a unique patient population

Multani¹,

Bajwa²,

MULTANI³

et al. 2022

Survey of Ophthalmology

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Clinical utility of pre-transplant ophthalmic consultation for lung transplant recipients: implications in the COVID-19 pandemic era

Cited by 3 publications

References 11 publications

Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic

Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic

A Measured Approach to Inpatient Ophthalmologic Screening in the COVID-19 Era: A Multicenter Perspective

Eye disease in kidney transplantation: Clinical challenges in a unique patient population

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