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Table 3 Summary of changes to logistics and procedural practices of intravitreal injection therapy (IVT) during the COVID-19 pandemic time

From: Are intravitreal injections essential during the COVID-19 pandemic? Global preferred practice patterns and practical recommendations

Country (city/region)

Prior to intravitreal injections being administered

Intravitreal Injection procedure

Screening for high risk COVID patients performed (temperature screen, symptoms, travel history)

High-risk COVID patients allowed to the specialist outpatient clinic for IVT

Changes to performing OCT imaging

Changes to performing ophthalmology consult

Changes to the setting where the majority of IVTs was performed

Changes to the skilled manpower used to administer IVT

Changes to the IVT administration procedure or equipment

Asia- Pacific

China(Guangzhou)

Yes

No

No

No

Yes, reduced numbers, social distancing, reduced follow up appointments

No

No

Israel(Tel Aviv)

Yes

No, deferred for 2 weeks

Yes, reduced OCT performed

Yes, reduced VA, slit-lamp exam

Yes, Reduced numbers and social distancingAn additional injection clinic opened outside the hospitalHome injections in selected cases

No

Yes, face shield and gown worn. N95 mask was available at physician’s discretion

Malaysia (Kuala Lumpur)

Yes

No, deferred

No

No

Yes, reduced numbers, social distancing, reduced follow up appointments

No

Yes, face shield was worn

Singapore

Yes

No, deferred

Yes, reduced OCT performed

Yes, reduced VA, slit-lamp exam

Yes, reduced numbers, reduced time in clinic, social distancing

No

Yes, goggles of face-shield recommended

Thailand (Bangkok)

Yes

Yes, if no fever detected

No

No

Yes, IVT clinic/OT stopped only IVT in the treatment room

No

No

Europe

France(Paris)

Yes

Yes

Yes, reduced OCT performed (no OCT in patients with known interval)

Yes, no slit lamp exam in patients with known interval

Yes, reduced numbers, reduced time in clinic, social distancing

No

No

Germany (Berlin)

Not formally

Yes, obviously sick patients asked to return later

No

Yes, telephone consults for patients instead of routine follow up examination

Yes, reduced numbers

No

No

Germany(Munich)

Yes

Yes, high risk cases screened in isolation

No

Yes, only VA, IOP, OCT taken no slit lamp exam

Yes, reduced numbers

No

No

Greece(Athens)

Yes

No

Yes, reduced OCT performed

Yes, reduced VA and slit-lamp exam

Yes, reduced numbers, social distancing

No

No

Italy(Rome)

Yes

No, deferred for 2 weeks

No

No

Yes, reduced numbers, social distancing

No

Yes, face shields worn by all staff

Italy(Milan)

Yes

Yes, high risk cases screened in isolation

No

Yes, telephone consults for symptoms screening

Yes, no injections in OT all IVT done in small procedures room

Yes, more senior ophthalmologists performing IVT as junior staff are deployed elsewhere

Yes, face shields worn by all staff

Switzerland (Lucerne)

No

Yes

Yes, reduced OCT, done only in treatment naïve patients and those patients with significant vision loss

Yes, no routine VA, IOP and slit lamp examination telephone consults done

Yes, reduced numbers, waiting time, social distancing

No

No

United Kingdom(London)

Yes

No, deferred for 2 weeks

Yes, reduced OCT performed

Yes, no routine VA, IOP or slit lamp exam performed

Yes, reduced numbers, waiting time, social distancing

No

No

United Kingdom (Wales)

Yes (department dependent)

No, deferred for 2 weeks

Yes, reduced OCT performed

Yes, no routine VA, IOP or slit lamp exam performed, virtual consults continue

Yes, reduced numbers, waiting time, social distancing

No

Yes, surgical mask strongly recommended

North and South America

Brazil(Recife)

Yes

No

No

Yes, included virtual consultations

Yes, reduced numbers, waiting time, social distancing

No

No

Canada(Vancouver)

No

Yes

No

Yes, DME and RVO patients contacted by telephone

No

No

Yes, gloves, goggles and masks for all staff, masks for any sick patients

Colombia(Cali)

Yes

No

Yes, reduced OCT performed

Yes, no pinhole or IOP, virtual consults where possible

No

No

Yes, face shield and gown worn. N95 mask was available at physician’s discretion

United States of America (Chicago)

Yes

Yes, high risk cases screened in isolation

Yes, only basic OCT allowed

No

Yes, reduced numbers, waiting time, social distancing

No

Yes

  1. VA: visual acuity, IOP: intraocular pressure, OCT: optical coherence tomography, DME: diabetic macula edema, RVO: retinal vein occlusions