Hybrid Telehealth Medical Retina Clinic Due to Provider Exposure and Quarantine During COVID-19 Pandemic

Hamzah Aweidah,1 Khaled Safadi,1 Alan Jotkowitz,2 Itay Chowers,1,* Jaime Levy1,* 1Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; 2Department of Internal Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel*These authors contributed equally to this workCorrespondence: Jaime LevyDepartment of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelEmail levjaime@gmail.comObjective: To present our hybrid telehealth medical retina clinic service with intravitreal injections (IVI) treatment as a safe alternative to in-person visits and examination during COVID-19 pandemic disease.Methods: Due to exposure to a COVID-19 positive retina fellow, our retina service, in quarantine, evaluated patients’ medical files and retinal scans using a telemedicine approach. A different protocol for patients coming for IVI during the COVID-19 pandemic was established for IVI administration.Results: During the 14-day quarantine period (between March 18th and March 31st 2020), the hybrid telehealth medical retina clinic performed 523 IVI to 394 patients with a mean age ± SD 70.96 ± 14.4 years. IVI were administered for neovascular age-related macular degeneration in 50.5% of the cases (199 patients), diabetic macular edema in 21.3% (84 patients), retinal vein occlusion in 17.5% (69 patients), and 10.7% for other retinal pathologies (42 patients). No ocular or systemic complications were observed.Conclusion: During disasters and pandemics, IVI can be provided safely using a hybrid telehealth medical retina clinic approach but only in the appropriate patient and health care system.Keywords: COVID-19, telemedicine, ophthalmology, intravitreal injections, hybrid telehealth medical retina clinic