Author: Leire Juaristi Eizmendi (Spain)
Co-authors: Cristina Irigoyen Laborra, Jaione Chapartegui Telleria, Ane Guibelalde Gonzalez
Purpose
To demonstrate that retina virtual clinic (RVC) is a useful and safe platform for monitoring selected retinal stable diseases during the COVID-19 pandemic decreasing COVID-19 virus expose and to assess patient satisfaction.
Setting/Venue
Prospective observational study of patients with stable retinal diseases such as diabetic retinopathy (DR), dry age-related macular degeneration (AMD), retinal vein occlusion (RVO), chronic central serous chorioretinopathy (CSC), choroidal nevus, hydroxychloroquine (HCQ) retinopathy screening, epiretinal membrane (ERM), vitelliform lesions and others: toxoplasma scar, macular telangiectasia…in the Ophthalmology Service of Donostia University Hospital (Spain) during the COVID-19 pandemic between September 2020 and March 2021.
Methods
All of the patients were attended in the RVC with measuring visual acuity (VA), intraocular pressure (IOP), optical coherence tomography (OCT) of the macula, wide field (WF) or ultra-wide-field (UWF) Clarus fundus retinography and visual field test (VF) in some cases. To evaluate the quality control of the RVC results, a double-blind-control was performed in some patients. Two different ophthalmologists reported the same case: on one hand the expert in RVC and on the other hand, the second ophthalmologist, in the face-to-face (F2F) clinic. It was compared if the outcome of RVC and the F2F clinic coincided. To assess patients satisfaction and their perceived quality of hospital care, it was utilized an adapted SERVQUAL model questionnaire.
Results
Four hundred eighty one patients were included in the study, 261 women and 220 men. The mean age was 67 years, SD ± 14, with a range between 18 and 97 years. Regarding the retinal disease condition, 93 patients (19.3%) were referred to F2F consultation due to; disease progression (57 patients (61.3%)) or for other reasons (38.7%): not suitable patients, added symptoms, poor image quality, preferred F2F. Thirty-two patients (6.6%) were discharged because of stable disease and 356 (74%) were eligible to continue at the RVC platform. The most frequent disease reviewed was DR (146 patients (30.3%)), followed by dry AMD (105 patients (21.8%)). One hundred fourteen patients (23.7%) had a double control of the RVC in a F2F consultation. Hundred percent of patients, who were not stable and needed treatment in the F2F control, had been diagnosed in RVC to refer to F2F clinic. The ophthalmologist could report twice more cases in RVC than in F2F clinic. RVC took less time for patients than the F2F clinic, 15 versus 25 minutes. Global satisfaction of patients in RVC, measured in the adapted SERVQUAL questionnaire, was 9.83 points out of 10. Three hundred ninety-two patients (81.5%) preferred RVC than F2F clinic.
Conlusions
The RVC is an additional platform that supports F2F clinic for the follow-up of patients with selected stable retinal diseases during times of pandemic. More than 70% of the patients could be seen in RVC safely. RVC decreases COVID-19 virus expose: the less time expended at the hospital, the less risk. Patients’ satisfaction is very good in RVC.
Financial Disclosure
Authors do not have financial relations
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