<p>Disaster Preparedness Impact In A Complex Ophthalmology Practice: A Review Of Patients Receiving Intravitreal Injections</p>

Abstract

Purpose: A private tertiary care ophthalmology practice was analyzed to see how Hurricane Irma affected patient care. Methods: Eighty-two patients (96 eyes) that missed their scheduled appointments due to Hurricane Irma were reviewed. Patients were being treated with intravitreal injection therapy for diabetic retinopathy, radiation retinopathy, vein occlusions, choroidal neovascularization, or neovascular age-related macular degeneration. The authors assessed patients' visual acuity and macular thickness changes before the hurricane and their initial visit after the storm. Emergency preparedness was also evaluated in this setting. Results: Patients on average were delayed 19.6 days. On average, best-corrected visual acuity was 20/97 (0.7 logMAR) before the hurricane and 20/82 (0.6 logMAR) after the storm. The average central macular thickness change was −1.30 μm. Intraocular pressure was not significantly affected and there were no ocular complications associated with the delay in therapy. A backup electrical system was in place to maintain appropriate temperature for storage of medications and proper access to medical records. Conclusion: The authors believe that minimizing delay in treatment was the most important contributing factor to preventing worsening of ocular disease. Ophthalmology clinics should strive for appropriate treatment modality regarding injection intervals prior to a natural disaster and emergency planning with excellent patient communication both before and after natural disasters.

Examining Global Crises: Extracting Insights From the COVID-19 Pandemic and Natural Disasters to Develop a Robust Emergency Diabetic Retinopathy Strategy for Puerto Rico

“…Teleophthalmology, mainly via portable devices, has the capacity to bridge accessibility gaps in remote and underserved communities. Research has demonstrated the feasibility of cost-effective DR screening tools utilizing smartphones and telemedicine, resulting in improved DR screening coverage in rural areas [ 15 ]. Furthermore, advancements in laser photocoagulation devices have enhanced precision and user-friendliness, making them well-suited for integration into telemedicine, thus enabling remote real-time consultation and expert care, which in turn improves therapeutic outcomes and reduces collateral retinal damage in the context of DR treatment [ 34 ].…”

“…Remarkably, as highlighted in Table 2, a significant portion of the reviewed studies evaluated the implications of delays in administering anti-vascular endothelial growth factor (anti-VEGF) treatment to patients with DR during the COVID-19 pandemic [14][15][16][17][18][19][20][21]. Noteworthy advances in DR screening and diagnostic technologies were a recurrent theme across multiple studies [22][23][24][25][26][27][28].…”

“…Anti-VEGF treatment delays during COVID- Intriguingly, the literature appeared to have a significant gap in the specific domain of disaster preparedness strategies tailored to DR during natural disasters [15], a point highlighted in Table 2. Only one article was identified to address this crucial aspect, emphasizing a potential avenue for future research.…”