Guidance for anti-VEGF intravitreal injections during the COVID-19 pandemic.
Identifieur interne : 000E82 ( Main/Exploration ); précédent : 000E81; suivant : 000E83Guidance for anti-VEGF intravitreal injections during the COVID-19 pandemic.
Auteurs : Jean-François Korobelnik [France] ; Anat Loewenstein [Israël] ; Bora Eldem [Turquie] ; Antonia M. Joussen [Allemagne] ; Adrian Koh [Singapour] ; George N. Lambrou [Suisse] ; Paolo Lanzetta [Italie] ; Xiaoxin Li [République populaire de Chine] ; Monica Lövestam-Adrian [Suède] ; Rafael Navarro [Espagne] ; Annabelle A. Okada [Japon] ; Ian Pearce [Royaume-Uni] ; Francisco J. Rodríguez [Colombie] ; David T. Wong [Canada] ; Lihteh Wu [Costa Rica]Source :
- Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [ 1435-702X ] ; 2020.
Descripteurs français
- KwdFr :
- Betacoronavirus (MeSH), Désinfection (MeSH), Facteur de croissance endothéliale vasculaire de type A (antagonistes et inhibiteurs), Humains (MeSH), Infections à coronavirus (prévention et contrôle), Injections intravitréennes (MeSH), Ophtalmologie (organisation et administration), Pandémies (prévention et contrôle), Pneumopathie virale (prévention et contrôle), Rétinopathies (traitement médicamenteux), Équipement de protection individuelle (MeSH).
- MESH :
- antagonistes et inhibiteurs : Facteur de croissance endothéliale vasculaire de type A.
- organisation et administration : Ophtalmologie.
- prévention et contrôle : Infections à coronavirus, Pandémies, Pneumopathie virale.
- traitement médicamenteux : Rétinopathies.
- Betacoronavirus, Désinfection, Humains, Injections intravitréennes, Équipement de protection individuelle.
English descriptors
- KwdEn :
- Betacoronavirus (MeSH), Coronavirus Infections (prevention & control), Disinfection (MeSH), Humans (MeSH), Intravitreal Injections (MeSH), Ophthalmology (organization & administration), Pandemics (prevention & control), Personal Protective Equipment (MeSH), Pneumonia, Viral (prevention & control), Retinal Diseases (drug therapy), Vascular Endothelial Growth Factor A (antagonists & inhibitors).
- MESH :
- chemical , antagonists & inhibitors : Vascular Endothelial Growth Factor A.
- drug therapy : Retinal Diseases.
- organization & administration : Ophthalmology.
- prevention & control : Coronavirus Infections, Pandemics, Pneumonia, Viral.
- Betacoronavirus, Disinfection, Humans, Intravitreal Injections, Personal Protective Equipment.
Abstract
PURPOSE
There is an urgent need to address how to best provide ophthalmic care for patients with retinal disease receiving intravitreal injections with anti-vascular endothelial growth factor agents during the ongoing global COVID-19 pandemic. This article provides guidance for ophthalmologists on how to deliver the best possible care for patients while minimizing the risk of infection.
METHODS
The Vision Academy's Steering Committee of international retinal disease experts convened to discuss key considerations for managing patients with retinal disease during the COVID-19 pandemic. After reviewing the existing literature on the issue, members put forward recommendations that were systematically refined and voted on to develop this guidance.
RESULTS
The considerations focus on the implementation of steps to minimize the exposure of patients and healthcare staff to COVID-19. These include the use of personal protective equipment, adherence to scrupulous hygiene and disinfection protocols, pre-screening to identify symptomatic patients, and reducing the number of people in waiting rooms. Other important measures include triaging of patients to identify those at the greatest risk of irreversible vision loss and prioritization of treatment visits over monitoring visits where possible. In order to limit patient exposure, ophthalmologists should refrain from using treatment regimens that require frequent monitoring.
CONCLUSION
Management of patients with retinal disease receiving intravitreal injections during the COVID-19 pandemic will require adjustment to regular clinical practice to minimize the risk of exposure of patients and healthcare staff, and to prioritize those with the greatest medical need. The safety of patients and healthcare staff should be of paramount importance in all decision-making.
DOI: 10.1007/s00417-020-04703-x
PubMed: 32328757
PubMed Central: PMC7179379
Affiliations:
- Allemagne, Canada, Colombie, Costa Rica, Espagne, France, Israël, Italie, Japon, Royaume-Uni, République populaire de Chine, Singapour, Suisse, Suède, Turquie
- Aquitaine, Berlin, Catalogne, Nouvelle-Aquitaine, Ontario, Région de Kantō
- Barcelone, Berlin, Bordeaux, Pékin, Tokyo, Toronto
- Université de Bordeaux, Université de Toronto
Links toward previous steps (curation, corpus...)
Le document en format XML
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Okada</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Pearce, Ian" sort="Pearce, Ian" uniqKey="Pearce I" first="Ian" last="Pearce">Ian Pearce</name><affiliation wicri:level="1"><nlm:affiliation>Royal Liverpool University Hospital, Liverpool, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Royal Liverpool University Hospital, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Rodriguez, Francisco J" sort="Rodriguez, Francisco J" uniqKey="Rodriguez F" first="Francisco J" last="Rodríguez">Francisco J. Rodríguez</name><affiliation wicri:level="1"><nlm:affiliation>Fundación Oftalmologia Nacional, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.</nlm:affiliation><country xml:lang="fr">Colombie</country><wicri:regionArea>Fundación Oftalmologia Nacional, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá</wicri:regionArea><wicri:noRegion>Bogotá</wicri:noRegion></affiliation></author><author><name sortKey="Wong, David T" sort="Wong, David T" uniqKey="Wong D" first="David T" last="Wong">David T. Wong</name><affiliation wicri:level="4"><nlm:affiliation>Unity Health Toronto - St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Unity Health Toronto - St. Michael's Hospital, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Wu, Lihteh" sort="Wu, Lihteh" uniqKey="Wu L" first="Lihteh" last="Wu">Lihteh Wu</name><affiliation wicri:level="1"><nlm:affiliation>Macula, Vitreous and Retina Associates of Costa Rica, San José, Costa Rica.</nlm:affiliation><country xml:lang="fr">Costa Rica</country><wicri:regionArea>Macula, Vitreous and Retina Associates of Costa Rica, San José</wicri:regionArea><wicri:noRegion>San José</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32328757</idno><idno type="pmid">32328757</idno><idno type="doi">10.1007/s00417-020-04703-x</idno><idno type="pmc">PMC7179379</idno><idno type="wicri:Area/Main/Corpus">001614</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001614</idno><idno type="wicri:Area/Main/Curation">001614</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">001614</idno><idno type="wicri:Area/Main/Exploration">001614</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Guidance for anti-VEGF intravitreal injections during the COVID-19 pandemic.</title><author><name sortKey="Korobelnik, Jean Francois" sort="Korobelnik, Jean Francois" uniqKey="Korobelnik J" first="Jean-François" last="Korobelnik">Jean-François Korobelnik</name><affiliation wicri:level="3"><nlm:affiliation>Service d'ophtalmologie, CHU Bordeaux, Bordeaux, France. jean-francois.korobelnik@chu-bordeaux.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'ophtalmologie, CHU Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Inserm, Bordeaux Population Health Research Center, team LEHA, Université de Bordeaux, UMR 1219, F-33000, Bordeaux, France. jean-francois.korobelnik@chu-bordeaux.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Inserm, Bordeaux Population Health Research Center, team LEHA, Université de Bordeaux, UMR 1219, F-33000, Bordeaux</wicri:regionArea><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName><orgName type="university">Université de Bordeaux</orgName></affiliation></author><author><name sortKey="Loewenstein, Anat" sort="Loewenstein, Anat" uniqKey="Loewenstein A" first="Anat" last="Loewenstein">Anat Loewenstein</name><affiliation wicri:level="1"><nlm:affiliation>Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.</nlm:affiliation><country xml:lang="fr">Israël</country><wicri:regionArea>Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv</wicri:regionArea><wicri:noRegion>Tel Aviv</wicri:noRegion></affiliation></author><author><name sortKey="Eldem, Bora" sort="Eldem, Bora" uniqKey="Eldem B" first="Bora" last="Eldem">Bora Eldem</name><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology, Hacettepe University, Ankara, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Ophthalmology, Hacettepe University, Ankara</wicri:regionArea><wicri:noRegion>Ankara</wicri:noRegion></affiliation></author><author><name sortKey="Joussen, Antonia M" sort="Joussen, Antonia M" uniqKey="Joussen A" first="Antonia M" last="Joussen">Antonia M. Joussen</name><affiliation wicri:level="3"><nlm:affiliation>Charité - University Medicine Berlin, Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Charité - University Medicine Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Koh, Adrian" sort="Koh, Adrian" uniqKey="Koh A" first="Adrian" last="Koh">Adrian Koh</name><affiliation wicri:level="1"><nlm:affiliation>Eye and Retina Surgeons, Camden Medical Centre, Singapore, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Eye and Retina Surgeons, Camden Medical Centre, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Lambrou, George N" sort="Lambrou, George N" uniqKey="Lambrou G" first="George N" last="Lambrou">George N. Lambrou</name><affiliation wicri:level="1"><nlm:affiliation>Global Medical Affairs Ophthalmology, Bayer, Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Global Medical Affairs Ophthalmology, Bayer, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Lanzetta, Paolo" sort="Lanzetta, Paolo" uniqKey="Lanzetta P" first="Paolo" last="Lanzetta">Paolo Lanzetta</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine - Ophthalmology, University of Udine, Udine, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medicine - Ophthalmology, University of Udine, Udine</wicri:regionArea><wicri:noRegion>Udine</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale Santa Maria della Misericordia, Udine, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Ophthalmology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale Santa Maria della Misericordia, Udine</wicri:regionArea><wicri:noRegion>Udine</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Istituto Europeo di Microchirurgia Oculare, IEMO, Udine, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Istituto Europeo di Microchirurgia Oculare, IEMO, Udine</wicri:regionArea><wicri:noRegion>Udine</wicri:noRegion></affiliation></author><author><name sortKey="Li, Xiaoxin" sort="Li, Xiaoxin" uniqKey="Li X" first="Xiaoxin" last="Li">Xiaoxin Li</name><affiliation wicri:level="3"><nlm:affiliation>Eye Center and Eye Institute, Peking University People's Hospital, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Eye Center and Eye Institute, Peking University People's Hospital, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Lovestam Adrian, Monica" sort="Lovestam Adrian, Monica" uniqKey="Lovestam Adrian M" first="Monica" last="Lövestam-Adrian">Monica Lövestam-Adrian</name><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology, Lund University Hospital, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Ophthalmology, Lund University Hospital, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Navarro, Rafael" sort="Navarro, Rafael" uniqKey="Navarro R" first="Rafael" last="Navarro">Rafael Navarro</name><affiliation wicri:level="3"><nlm:affiliation>Instituto Microcirugia Ocular, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Instituto Microcirugia Ocular, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Okada, Annabelle A" sort="Okada, Annabelle A" uniqKey="Okada A" first="Annabelle A" last="Okada">Annabelle A. Okada</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Pearce, Ian" sort="Pearce, Ian" uniqKey="Pearce I" first="Ian" last="Pearce">Ian Pearce</name><affiliation wicri:level="1"><nlm:affiliation>Royal Liverpool University Hospital, Liverpool, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Royal Liverpool University Hospital, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Rodriguez, Francisco J" sort="Rodriguez, Francisco J" uniqKey="Rodriguez F" first="Francisco J" last="Rodríguez">Francisco J. Rodríguez</name><affiliation wicri:level="1"><nlm:affiliation>Fundación Oftalmologia Nacional, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.</nlm:affiliation><country xml:lang="fr">Colombie</country><wicri:regionArea>Fundación Oftalmologia Nacional, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá</wicri:regionArea><wicri:noRegion>Bogotá</wicri:noRegion></affiliation></author><author><name sortKey="Wong, David T" sort="Wong, David T" uniqKey="Wong D" first="David T" last="Wong">David T. Wong</name><affiliation wicri:level="4"><nlm:affiliation>Unity Health Toronto - St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Unity Health Toronto - St. Michael's Hospital, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Wu, Lihteh" sort="Wu, Lihteh" uniqKey="Wu L" first="Lihteh" last="Wu">Lihteh Wu</name><affiliation wicri:level="1"><nlm:affiliation>Macula, Vitreous and Retina Associates of Costa Rica, San José, Costa Rica.</nlm:affiliation><country xml:lang="fr">Costa Rica</country><wicri:regionArea>Macula, Vitreous and Retina Associates of Costa Rica, San José</wicri:regionArea><wicri:noRegion>San José</wicri:noRegion></affiliation></author></analytic><series><title level="j">Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie</title><idno type="eISSN">1435-702X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Betacoronavirus (MeSH)</term><term>Coronavirus Infections (prevention & control)</term><term>Disinfection (MeSH)</term><term>Humans (MeSH)</term><term>Intravitreal Injections (MeSH)</term><term>Ophthalmology (organization & administration)</term><term>Pandemics (prevention & control)</term><term>Personal Protective Equipment (MeSH)</term><term>Pneumonia, Viral (prevention & control)</term><term>Retinal Diseases (drug therapy)</term><term>Vascular Endothelial Growth Factor A (antagonists & inhibitors)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Betacoronavirus (MeSH)</term><term>Désinfection (MeSH)</term><term>Facteur de croissance endothéliale vasculaire de type A (antagonistes et inhibiteurs)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (prévention et contrôle)</term><term>Injections intravitréennes (MeSH)</term><term>Ophtalmologie (organisation et administration)</term><term>Pandémies (prévention et contrôle)</term><term>Pneumopathie virale (prévention et contrôle)</term><term>Rétinopathies (traitement médicamenteux)</term><term>Équipement de protection individuelle (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="antagonists & inhibitors" xml:lang="en"><term>Vascular Endothelial Growth Factor A</term></keywords><keywords scheme="MESH" qualifier="antagonistes et inhibiteurs" xml:lang="fr"><term>Facteur de croissance endothéliale vasculaire de type A</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Retinal Diseases</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Ophtalmologie</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Ophthalmology</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Coronavirus Infections</term><term>Pandemics</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Infections à coronavirus</term><term>Pandémies</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Rétinopathies</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>Disinfection</term><term>Humans</term><term>Intravitreal Injections</term><term>Personal Protective Equipment</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Betacoronavirus</term><term>Désinfection</term><term>Humains</term><term>Injections intravitréennes</term><term>Équipement de protection individuelle</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>PURPOSE</b></p><p>There is an urgent need to address how to best provide ophthalmic care for patients with retinal disease receiving intravitreal injections with anti-vascular endothelial growth factor agents during the ongoing global COVID-19 pandemic. This article provides guidance for ophthalmologists on how to deliver the best possible care for patients while minimizing the risk of infection.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>The Vision Academy's Steering Committee of international retinal disease experts convened to discuss key considerations for managing patients with retinal disease during the COVID-19 pandemic. After reviewing the existing literature on the issue, members put forward recommendations that were systematically refined and voted on to develop this guidance.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The considerations focus on the implementation of steps to minimize the exposure of patients and healthcare staff to COVID-19. These include the use of personal protective equipment, adherence to scrupulous hygiene and disinfection protocols, pre-screening to identify symptomatic patients, and reducing the number of people in waiting rooms. Other important measures include triaging of patients to identify those at the greatest risk of irreversible vision loss and prioritization of treatment visits over monitoring visits where possible. In order to limit patient exposure, ophthalmologists should refrain from using treatment regimens that require frequent monitoring.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Management of patients with retinal disease receiving intravitreal injections during the COVID-19 pandemic will require adjustment to regular clinical practice to minimize the risk of exposure of patients and healthcare staff, and to prioritize those with the greatest medical need. The safety of patients and healthcare staff should be of paramount importance in all decision-making.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32328757</PMID><DateCompleted><Year>2020</Year><Month>05</Month><Day>21</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1435-702X</ISSN><JournalIssue CitedMedium="Internet"><Volume>258</Volume><Issue>6</Issue><PubDate><Year>2020</Year><Month>Jun</Month></PubDate></JournalIssue><Title>Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie</Title><ISOAbbreviation>Graefes Arch. Clin. Exp. Ophthalmol.</ISOAbbreviation></Journal><ArticleTitle>Guidance for anti-VEGF intravitreal injections during the COVID-19 pandemic.</ArticleTitle><Pagination><MedlinePgn>1149-1156</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00417-020-04703-x</ELocationID><Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">There is an urgent need to address how to best provide ophthalmic care for patients with retinal disease receiving intravitreal injections with anti-vascular endothelial growth factor agents during the ongoing global COVID-19 pandemic. This article provides guidance for ophthalmologists on how to deliver the best possible care for patients while minimizing the risk of infection.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">The Vision Academy's Steering Committee of international retinal disease experts convened to discuss key considerations for managing patients with retinal disease during the COVID-19 pandemic. After reviewing the existing literature on the issue, members put forward recommendations that were systematically refined and voted on to develop this guidance.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The considerations focus on the implementation of steps to minimize the exposure of patients and healthcare staff to COVID-19. These include the use of personal protective equipment, adherence to scrupulous hygiene and disinfection protocols, pre-screening to identify symptomatic patients, and reducing the number of people in waiting rooms. Other important measures include triaging of patients to identify those at the greatest risk of irreversible vision loss and prioritization of treatment visits over monitoring visits where possible. In order to limit patient exposure, ophthalmologists should refrain from using treatment regimens that require frequent monitoring.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Management of patients with retinal disease receiving intravitreal injections during the COVID-19 pandemic will require adjustment to regular clinical practice to minimize the risk of exposure of patients and healthcare staff, and to prioritize those with the greatest medical need. The safety of patients and healthcare staff should be of paramount importance in all decision-making.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Korobelnik</LastName><ForeName>Jean-François</ForeName><Initials>JF</Initials><AffiliationInfo><Affiliation>Service d'ophtalmologie, CHU Bordeaux, Bordeaux, France. jean-francois.korobelnik@chu-bordeaux.fr.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Inserm, Bordeaux Population Health Research Center, team LEHA, Université de Bordeaux, UMR 1219, F-33000, Bordeaux, France. jean-francois.korobelnik@chu-bordeaux.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loewenstein</LastName><ForeName>Anat</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eldem</LastName><ForeName>Bora</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology, Hacettepe University, Ankara, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Joussen</LastName><ForeName>Antonia M</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Charité - University Medicine Berlin, Berlin, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koh</LastName><ForeName>Adrian</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Eye and Retina Surgeons, Camden Medical Centre, Singapore, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lambrou</LastName><ForeName>George N</ForeName><Initials>GN</Initials><AffiliationInfo><Affiliation>Global Medical Affairs Ophthalmology, Bayer, Basel, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lanzetta</LastName><ForeName>Paolo</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Medicine - Ophthalmology, University of Udine, Udine, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Ophthalmology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale Santa Maria della Misericordia, Udine, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Istituto Europeo di Microchirurgia Oculare, IEMO, Udine, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Xiaoxin</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Eye Center and Eye Institute, Peking University People's Hospital, Beijing, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lövestam-Adrian</LastName><ForeName>Monica</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology, Lund University Hospital, Lund, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Navarro</LastName><ForeName>Rafael</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Instituto Microcirugia Ocular, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Okada</LastName><ForeName>Annabelle A</ForeName><Initials>AA</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pearce</LastName><ForeName>Ian</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Royal Liverpool University Hospital, Liverpool, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rodríguez</LastName><ForeName>Francisco J</ForeName><Initials>FJ</Initials><AffiliationInfo><Affiliation>Fundación Oftalmologia Nacional, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wong</LastName><ForeName>David T</ForeName><Initials>DT</Initials><AffiliationInfo><Affiliation>Unity Health Toronto - St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wu</LastName><ForeName>Lihteh</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Macula, Vitreous and Retina Associates of Costa Rica, San José, Costa Rica.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>04</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Graefes Arch Clin Exp Ophthalmol</MedlineTA><NlmUniqueID>8205248</NlmUniqueID><ISSNLinking>0721-832X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D042461">Vascular Endothelial Growth Factor A</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Graefes Arch Clin Exp Ophthalmol. 2020 Jun;258(6):1335-1337</RefSource><PMID Version="1">32322965</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName 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