Four panels of physicians and industry representatives share experiences and valuable insights on how to smartly and efficiently adapt to the new COVID era.

Euretina – New paradigms in intravitreal nAMD care, new ideas for the upcoming home monitoring and delivery of care, the delicate relationship between social distance and surgery and how physicians can protect themselves and the patient in preparation for a second wave. A very insightful discussion took place during the 2020 virtual Euretina Meeting, chaired by Frank. G. Holz, Anat Loewenstein, Adnan Tufail and Sebastian Wolf.

Important take-home messages were expressed during the four parts of the session. The problem of intravitreal treatment discontinuity during the pandemic and the consequent loss of vision was tackled by Adnan Tufail, Cesare Mariotti and Jean-François Korobelnik.
“About 20-30% of the patients did not come. Many of them were afraid because they were old and at risk. Some had really big issues with transportation: they couldn’t find a driver or someone in the family to bring them to the hospital”, Korobelnik said. 

Home monitoring and home care delivery offered opportunities in response to the crisis, and will more and more become an option for the future to come, according to Anat Loewenstein.
“We reached out to patient’s and delivered the injection at home, using a special mobile unit”, said Loewenstein. “Also, the Home-monitoring OCT is under clinical trial in Israel”, she added.

In hospital settings, preparedness, precautions and protective strategies have been fundamental to lower risks during routine clinical practice and surgery.
“In the clinic we wore full protective attire, made sure all seats were spread out and we deferred a lot of patients in order to maintain enough safe space”, said Robin Hamilton. “We did not do OCT, slit lamp and visual acuity unless there was a specific issue from the patient”, he said. “During the lockdown we decided to maintain the last extended period of the T&E protocol treatment”, José García-Arumí said.

Surgery now needs to be synchronous with testing to ensure safety, according to Ramin Tadayoni. “Many private laboratoires take still a few days to provide the results of a covid test, and given that we have been asked to do it to all patients before surgery this has become a technical issue”, Tadayoni said. “A result from a test made 5 days prior to surgery has little or no value. A test must be done within two days from a surgery, and that requires a complex organisational effort”, he noted..

In the last part of the session, the role of digital technology in the COVID-19 crisis was analysed, with particular regard to the new virtual format of the Euretina Congress. “There are lots of advantages in virtual meetings”, said Sergio Leal, Director, Global Clinical Leader at Bayer. We can now bring everyone together at the same time on the same platform in a very efficient way and save time for everyone”, he said. “At the same time we unfortunately lose a social component that makes meetings richer, and that’s a downside”, he pointed out.
“The real business sometimes happens at the end of a meeting, over a glass of wine” Tufail said. “That’s the moment where a little insight leads to great ideas and great collaborations, and I miss that”, he concluded.