03.31.20

New Retina Radio: Experts Discuss New Patient Protocols in COVID-19 Era

Source: Eyewire News

New Retina Radio has launched a new series covering the COVID-19 crisis featuring retina specialists around the world talking about how their practices have been affected. In the first episode of this series, host John W. Kitchens, MD, was joined by Rishi Singh, MD; Nancy Holekamp, MD; and Sunir Garg, MD, to discuss new patient protocols, staffing complications, and working with colleagues who are at risk for contracting COVID-19.

Here is a summary of topics discussed during the webcast:

Types of Patients You Are Seeing

Dr. Kitchens: And are you changing the way you see patients? The types of patients you see? Are you rescheduling patients? How are you handling surgeries at this time?

Dr. Singh: We’re following the AAO’s recommendations to cancel all elective cases. We’re doing emergent surgeries for patients with RDs and endophthalmitis, and for glaucoma patients who have really high pressures who need surgery. I did five cases yesterday with patients in the OR for all of those reasons. In clinic, we’re deferring as many of the routine examinations as we can, such as routine diabetic eye disease cases. We still see our AMD patients, but we are pursuing an aggressive treat-and-extend regimen with all cases possible.

For patients with diabetic eye disease, there is less evidence that a deferral of the injection matters. I have data that we actually just worked on recently at Cole Eye that looked at patients with unintended 3-month lapses in treatment, and the numbers show there’s really no detriment to missing treatment compared to those who followed-up. We’re using that data to our benefit to defer our diabetic patients who obviously have other systemic comorbidities.

Patients Enrolled in Clinical Trials

Dr. Kitchens: You’re very involved in clinical trials and clinical studies. How are you handling those patients?

Dr. Holekamp: A lot of people talk about urgent or emergent care. I like to talk about essential care because I’m not sure anyone can say that an injection is an emergency, but it’s essential to our AMD patients.

We are participating in AMD clinical trials, and those patients are getting treated per the trial protocol. I think it’s very important to maintain those visits. We’re streamlining them and getting guidance from trial sponsors to collect just the bare essential data and provide protocol treatments. We have put screening and new randomizations on pause, and that’s been agreed upon across all of our clinical trials.

How to Talk to Older Patients About Changes

Dr. Kitchens: Mid Atlantic Retina is a storied practice with some older partners. What are you telling them to do?

Dr. Garg: We have a couple of partners that are more senior. We asked one of them to not come into work for at least 2 weeks. How that request changes over the next few weeks as this crisis intensified, I don’t know. Among our other older partners, a few have health issues that place them at risk. We’re encouraging them to reduce how often they come in. But we’re leaving it to their discretion.

The full episode of the webcast can be found here.

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