Glaucoma management in pandemic: A review - ASCRS, 7/25/2021 Frances Meier-Gibbons Switzerland - Thriving ...
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Glaucoma management in pandemic:
A review
Frances Meier-Gibbons
Switzerland
ASCRS, 7/25/2021
Financial disclosures: Not relevant for this presentation
Citations in pub med
Pub med access 17.7.21:
- Covid 19: 176’418 studies
- Covid 19 in ophthalmology: 2955 studies
- Covid 19 in glaucoma: 1035 studies
- Covid 19 in glaucoma management: 712 studies
- Covid 19 in ophthalmic surgery: 786 studies
- Pandemics and glaucoma: 288 studies
© FMG 2021
Covid – a new disease? Coronaviruses: - Single-stranded RNA viruses, causing diseases in a variety of hosts including humans and different animals - Until 2019, 6 strands of pathogenic human viruses known, 4 of these causing 1/3 of common colds and 2 causing severe respiratory illnesses (SARS-CoV in 2002 and MERS-CoV in 2012) - December 2019: New virus, SARS-CoV2, disease Covid-19, declared a pandemic on March 11, 2020 Kutti-Sridharan G et al. Int J.Med. 2020 Jul 9;11:97. © FMG 2021
SARS-CoV2 Coronaviruses: - Transmission: Droplets, aerosols, feco-oral, saliva, tears (not often!) - Live on objects up to 72 hours - Ophthalmic symptoms: Mainly conjunctivitis / few intraocular manifestations – cave thromboembolic complications Kutti-Sridharan G et al. Int J.Med. 2020 Jul 9;11:97 Ho D et al. Ocul Immunol Inflamm. 2020 Jul 3;28(5):726-734. © FMG 2021
Glaucoma management
History: Family history, risk factors
Diagnostics: Slit-lamp examination, IOP, goniscopy, CCT, visual field
examination, ONH examination
Therapy: medical therapy, laser, surgery
Follow-up procederes: Side effects of therapy, progression
Where does Covid 19 interfere? Mainly diagnostics
and surgical therapy
© FMG 2021Shields do protect, but other measures are needed too1
Liu J et al. Am J Ophthalmol. 2020;218:120-127
© FMG 2021SARS-CoV2 Publications: - Influence of masks in IOP measurements, on ocular surface and in visual field testing - Interestingly not much influence on air-puff tonometry - Increase of contacts to patients via telemedicine. Discussable approach: First consultation in person, second via telemedicine - Surgery: Desinfection of instruments with 70% alcohol, topical 5% povidone-iodine Davanian AM et al. Journal of Glaucoma. 2021;30(3):e47–e49 Shetty R et al. J Glaucoma. 2020 Nov;29(11):1006-1016 Mastropasqua L. et al. Transl Vis Sci Technol. 2021;10(3):22 Soleimani M et al. Int J Ophthalmol. 2021;14(5):639-642. Published 2021 May 18 © FMG 2021 Bayram N. et al. Journal of Glaucoma: April 2021;Volume 30. Issue 4 - p 287-292
Take home messages
How does Covid-19 influence glaucoma management?
- New stratification models: Risk of life-time vision loss because of
glaucoma versus uncertain risk of Covid infection arising from hospital-
based eye-care.
- New tools: Online-consultations / home IOP-monitoring / digital
strategy to integrate external visual field and ONH-examinations /
drive-through clinics
- Very important: Optimize the office / hospital settings to ensure the
patient that he/she is safe
Jayaram H et al. Eye (Lond). 2020 Jul;34(7):1203-1205
Baughman BD et al. mJournal of Glaucoma: March 2021 - Volume 30 - Issue 3 - p 223-226
Newman-Casey PA et al. Am J Ophthalmol. 2021;S0002-9394(21)00213-0
Prager KM et al. Am J Ophthalmol. 2021;224:158-162. © FMG 2021Thank you for your attention! Oldfield E et al. ACS Infect Dis. 2020 Jul 10;6(7):1563-1566. © FMG 2021
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