1.COVID-19 guidance on the resumption of eye surgery
Jacqueline H. King ; Jubaida M. Aquino ; Rachelle G. Anzures ; John Mark S. de Leon ; Maria Victoria A. Rondaris ; Maria Donna D. Santiago ; Cynthia V. Verzosa
Philippine Journal of Ophthalmology 2021;46(1):2-14
This document offers guidance to help the ophthalmologist plan for the safe resumption of elective surgical care.
There are 4 sections: (I) COVID-19 Awareness, (II) Preparedness, (III) Patient Issues, and (IV) Delivery of Safe
and High-Quality Care. Each section contains key issues to be addressed before elective surgery may be safely
reinstituted.
Understanding the capabilities of health facilities (e.g., testing, operating rooms) as well as the potential limitations
in manpower and supplies will remain important, while keeping an eye out on subsequent waves of COVID-19.
COVID-19
2.COVID-19 testing recommendations prior to elective ophthalmic surgeries
Jacqueline H. King ; Jubaida M. Aquino ; Rachelle G. Anzures ; John Mark S. de Leon ; Maria Victoria A. Rondaris ; Maria Donna D. Santiago ; Cynthia V. Verzosa
Philippine Journal of Ophthalmology 2021;46(1):15-19
With the resumption of elective surgeries during this COVID-19 pandemic, surgeons and facilities should implement
infection prevention and control measures to ensure the safety of patients and health care workers. This advisory
highlights the key principles, risk stratification considerations, and recommended approach regarding Covid-19
testing prior to elective ophthalmic surgeries.
COVID-19
3.Clinical profile and treatment outcomes of patients with Neovascular Glaucoma in a Tertiary Hospital in the Philippines
Angela Therese Y. Uy ; John Mark S. de Leon ; Jubaida M. Aquino
Philippine Journal of Ophthalmology 2021;46(2):82-87
Objective:
To report the clinical profile and treatment outcomes of neovascular glaucoma (NVG).
Methods:
A retrospective cohort study was done in a single tertiary hospital. Medical records of patients diagnosed
with NVG from January 2000 to August 2018 were reviewed and pertinent data were collected. Study outcomes
included visual acuity (VA) and intraocular pressure (IOP) and were analyzed for eyes that received any of the
following: intravitreal bevacizumab (IVBe), pan-retinal photocoagulation (PRP), trabeculectomy with mitomycin
(trab-MMC), or diode laser cyclophotocoagulation (DLCP) with at least 1 month of follow-up.
Results:
There were 162 patients (181 eyes) diagnosed with NVG. Mean age at the time of diagnosis was 55.6 ± 14
years. Diabetic retinopathy (DR) was observed in 81 (45%) eyes and central retinal vein occlusion (CRVO) in 48
(27%) eyes. Baseline VA was hand movement in 67 (37%) eyes and no light perception (NLP) in 49 (27%) eyes.
Only 60 (33%) eyes had ≥1 month of follow up (mean of 73 ± 119.1 weeks) after procedures were done. IVBe
was done in 22 (37%) eyes, trab-MMC in 20 (33%), PRP in 22 (37%), and DLCP in 24 (40%) eyes. IOP decreased
from 45 to 20 mmHg (p<0.001) but VA decreased from LogMAR 1.7 to 2.1 (p<0.01). There was significant VA
decrease in eyes that underwent a single procedure (p<0.02) but none in eyes that underwent 2 or 3 procedures.
Nonetheless, there was significant IOP decrease (p<0.05) when one procedure was done. Of the 49 eyes that had
baseline sight, 19 (41%) converted to NLP (p<0.01).
Conclusion
Most patients presenting with advanced NVG had DR and CRVO. Procedures led to better IOP
but not VA and some lost vision. Aggressive screening for NVG among high-risk groups is warranted to institute
treatment early.
Bevacizumab
;
Retinal Vein Occlusion
;
Diabetic Retinopathy
;
Glaucoma, Neovascular
;
Trabeculectomy
4.Current practices in treating retinopathy of prematurity in the Philippines
Kristine G. Pormida ; Jocelyn L. Sy ; Jubaida M. Aquino
Philippine Journal of Ophthalmology 2024;49(2):95-105
OBJECTIVE
To identify the current practices of ophthalmology subspecialists involved in the treatment of retinopathy of prematurity (ROP) in the Philippines.
METHODSA survey was conducted among members of the Vitreo-Retina Society of the Philippines (VRSP) and the Philippine Society of Pediatric Ophthalmology and Strabismus (PSPOS) who treat ROP. The electronic questionnaire covered treatment preferences and factors influencing these preferences regarding the use of anti-vascular endothelial growth factor (anti-VEGF), laser indirect ophthalmoscopy (LIO), cryotherapy, and surgical interventions. Questions about referral system and ROP recurrences encountered by the respondents were included.
RESULTSA total of 73 out of 86 (85.00% response rate) possible respondents were included in the study, majority (80.82%) of whom were retina subspecialists. The initial treatment preference for type 1 ROP was laser indirect ophthalmoscopy (43.84%), while anti-VEGF injection (67.12%) was preferred for aggressive posterior ROP (APROP). Among the available anti-VEGF agents, bevacizumab was the most favored (68.11%). Most ROP consultations (59.79%) occurred through referrals, primarily from pediatricians or neonatologists (91.78%). Subspecialists reported encountering more recurrences with anti-VEGF injections compared to LIO. LIO was the most preferred treatment after failed initial anti-VEGF therapy, with most recurrences occurring in patients older than 50 weeks post-conceptual age.
CONCLUSIONThis study underscored the diverse treatment practices for ROP in the Philippines, influenced by factors such as variable access to equipment or drugs, clinician experience with specific treatments, and ocular factors such as faster regression of neovascularization. LIO was preferred as the initial therapy for Type 1 ROP and for managing recurrences, while anti-VEGF injections were favored for APROP and as an alternative treatment for Type 1 ROP. Given the absence of an established standard for treating recurrent ROP cases, long-term monitoring is necessary to facilitate timely interventions and prevent blindness.
Retinopathy Of Prematurity ; Bevacizumab