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COVID-19'S IMPACT EARN 2 CE CREDITS: Maximizing OCT in the Diagnosis of Glaucoma, p. 76 May 15, 2020 www.reviewofoptometry.com COVID-19’s IMPACT …and How Optometry Can Bounce Back THERE’S RELIEF AND THEN THERE’S Its disruptions were swift and seismic, but ODs are ready to move on. • Planning for Post-COVID Life, p. 3 • Patient Care Morphs During COVID-19, p. 30 • 20 Tips FORFor Reopening DRY, Amid COVID-19, IRRITATED p. 36 EYES. The only family of products in the U.S. with CMC, HA (inactive ingredient), and HydroCell™ technology. ALSO: 21st Annual Dry Eye Report, begins p. 42 refreshbrand.com/doc Statins and the Eye: What You May Not Know, p. 62 © 2020 Allergan. All rights reserved. All trademarks are the property of their respective owners. REF127591 08/19 Five Cases You Shouldn’t Refer, p. 68 EARN 2 CE CREDITS: Maximizing OCT in the Diagnosis of Glaucoma, p. 76 May 15, 2020 www.reviewofoptometry.com COVID-19’s IMPACT …and How Optometry Can Bounce Back Its disruptions were swift and seismic, but ODs are ready to move on. • Planning for Post-COVID Life, p. 3 • Patient Care Morphs During COVID-19, p. 30 • 20 Tips For Reopening Amid COVID-19, p. 36 ALSO: 21st Annual Dry Eye Report, begins p. 42 Statins and the Eye: What You May Not Know, p. 62 Five Cases You Shouldn’t Refer, p. 68 INTRODUCING VISUAL FIELD SUITE M&S | Melbourne Rapid Fields (MRF) Revolutionary Visual Field Testing MRF is a simple solution, meticulously designed and calibrated to perform Visual Field tests in-clinic and at home, developed by a name you can trust. Optimize your practice with revolutionary Visual Field testing. M&S offers 2 options for state of the art, accurate, reliable testing. The In-Clinic testing offers a unique space saving design. The simple user friendly interface allows for reduced test time, progression analysis and low anxiety for the patient. Our advanced Web-based software makes at-home visual field testing a viable alternative to office visits. This offers convenient scheduling for both patient and doctor. Immediate reliable HFA style report is securely transmitted to the doctor. Record patient progression with ease and confidence. Peer review and published research by leading journals. Keep clinics safe. Sanitizes in under 2 minutes. The First Choice in Vision Testing Systems TM Made in America 847-763-0500 mstech-eyes.com Powered by: EyeSimplify © 2020 M&S Technologies, Inc. Smart System and M&S are registered trademarks of M&S Technologies. All rights reserved. M&S holds US Patents 7,354,155; 7,926,948; 8,425,040; 8,167,429; 8,419,184; 8,550,631; 10,244,938 and 10,182,713. Other Patents Pending. NewsNews ReviewReview VOL. 157 NO. 5 n MAY 15, 2020 IN THE NEWS Practices Plan for A recent study found that pharma- cological pupil dilation worsened Post-COVID Life angle closure in half of untreated acute primary angle closure (APAC) patients ECPs look to make a return to normalcy an with narrow angles. Swept-source OCT immediate reality. By Mark De Leon, Associate Editor captured 360-degree scans of the angles of 106 APAC patients older than age 50 tate-mandated shutdowns en- distance, by relying on phone calls before and one hour after dilation. Angle acted as the coronavirus spread (78.6% of respondents) and video or narrowing was also associated with a Sacross the United States have photo consultations (81.6%). This shallower anterior chamber and a bigger left the eye care profession largely on correlates with a similar increase lens vault. hiatus since mid-March, but prac- in patients’ curiosity in accessing Narayanaswamy A, Baskaran M, Tun TA, et al. Effect of tices are now prepping to reopen, remote services, as 41.4% of respon- pharmacological pupil dilatation on angle configuration in untreated primary angle closure suspects: a swept source albeit with downscaled services and dents reported their patients current anterior segment optical coherence tomography study. J Glaucoma. March 27, 2020. [Epub ahead of print]. realistic ambitions for the near term. express interest, compared with After restricting services to emer- 17.3% at the start of the crisis. A recent study found that patients gency appointments only, attempt- Optometrists have gotten used to with mild cognitive impairment and ing telemedicine consults and using billing telehealth consultations as Alzheimer’s disease experienced unconventional methods to stay in well, as the initial 26% who were anatomical and functional retinal touch with patients, optometrists comfortable with billing telehealth changes, including reductions in have resumption of business on their in mid-March has grown to about nerve fiber layer thickness, arterial mind but are unsure on how to put 70% of respondents who report blood flow, arterial vessel diameter and arteriovenous difference in oxygen that into action. having done so in the past two saturation. “This indicates alterations in To track both the sentiment weeks (Figure 1). Those doing so are retinal oxygen metabolism in patients and circumstances of a profession starting to feel more confident with with neurodegenerative disease,” the operating in crisis mode, Jobson the process, with only 25.2% saying researchers concluded in their paper. (publisher of Review of Optometry) they needed help in mid-April vs. Szegedi S, Dal-Bianco P, Stögmann E, et al. Anatomical and launched a weekly survey in mid- 32.4% one month prior. functional changes in the retina in patients with Alzheimer’s March. Data through late April (Continued on p. 7) disease and mild cognitive impairment. Acta Ophthalmo- logica. March 25, 2020. [Epub ahead of print]. show eye care practitioners Source: Fig. 1. Have You Billed for Telehealth (ECPs) still reeling—respon- Jobson Services in the Last Two Weeks? Researchers recently found that the dents pegged their career- ECP trajectory of functional decline in eyes related stress at 7.0 on a Coronavirus treated for wet AMD was greater than 1-10 scale—but ready to what has been reported. After monitor- rebound. ing patients for approximately three Survey years, the team reported a median dis- Open to Telehealth (Wave tance visual acuity (DVA) of 58.0 letters, The crisis continues to push 7) which decreased by 4.3 letters per year. doctors to offer telehealth This rate was not influenced by injection rate after adjusting for key covariates. services. According to the DVA was similar among patients, regard- most recent Jobson ECP less of whether they switched between Coronavirus Survey (Wave ranibizumab and aflibercept. 7), optometrists are still Evans RN, Reeves BC, Phillips D, et al. Long-term outcomes keeping up with patients of usual care in patients with neovascular age-related while maintaining their macular degeneration in the IVAN trial. Ophthalmology. March 27, 2020. [Epub ahead of print]. NEWS STORIES POST EVERY WEEKDAY MORNING AT www.reviewofoptometry.com/news REVIEW OF OPTOMETRY MAY 15, 2020 3 Help your patients with DIABETIC RETINOPATHY (DR), and HELP DRIVE PATIENT OUTCOMES Through early detection, monitoring, and timely referral, you can play a pivotal role in managing your DR patients’ vision1-3 IF YOU SEE OR SUSPECT DR: Educate your patients Refer Follow up about living with DR and DR patients for timely to ensure they potential treatment options2,3 intervention have visited a • According to the AOA, you retina specialist should refer patients with2,3 – Severe nonproliferative DR (NPDR) within 2 to 4 weeks – Proliferative DR (PDR) within 1 week INDICATIONS AND IMPORTANT SAFETY INFORMATION EYLEA® (aflibercept) Injection 2 mg (0.05 mL) is indicated for the treatment of patients with Neovascular (Wet) Age-related Macular Degeneration (AMD), Macular Edema following Retinal Vein Occlusion (RVO), Diabetic Macular Edema (DME), and Diabetic Retinopathy (DR). CONTRAINDICATIONS • EYLEA is contraindicated in patients with ocular or periocular infections, active intraocular inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA. WARNINGS AND PRECAUTIONS • Intravitreal injections, including those with EYLEA, have been associated with endophthalmitis and retinal detachments. Proper aseptic injection technique must always be used when administering EYLEA. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately. Intraocular inflammation has been reported with the use of EYLEA. References: 1. Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12. Ophthalmology. 1991;98(5 suppl):823-833. 2. Care of the Patient With Diabetes Mellitus: Quick Reference Guide. American Optometric Association website. http://bit.ly/2M22OUJ. Accessed August 7, 2019. 3. Ferrucci S, Yeh B. Diabetic retinopathy by the numbers. Rev Optom. June 15, 2016. http://bit.ly/2KNNJ4E. Accessed August 7, 2019. EYLEA is a registered trademark of Regeneron Pharmaceuticals, Inc. © 2020, Regeneron Pharmaceuticals, Inc. All rights reserved. 777 Old Saw Mill River Road, Tarrytown, NY 10591 Brought to you by REGENERON Visit diabeticretinaldisease.com for additional information and useful patient resources Continue to monitor The more you know about emerging clinical your patients with DR2,3 science about anti-VEGF and other potential therapies • The AOA recommends frequent for DR, the better you can help inform your patients monitoring of patients2 about how treatment may be able to help – At least every 6 to 8 months in Refer patients to a retina specialist patients with moderate NPDR who can treat DR2,3 and more frequently for patients with greater disease severity2 WARNINGS AND PRECAUTIONS (cont’d) • Acute increases in intraocular pressure have been seen within 60 minutes of intravitreal injection, including with EYLEA. Sustained increases in intraocular pressure have also been reported after repeated intravitreal dosing with VEGF inhibitors. Intraocular pressure and the perfusion of the optic nerve head should be monitored and managed appropriately.
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