Impact of the COVID-19 Pandemic on Retinopathy of Prematurity Practice: An Indian Perspective
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MANGLA SOOD1 AND SEEMA SHARMA2* From 1Departments of Pediatrics, Indira Gandhi Medical College, Shimla; and 2Dr Rajendra Prasad Government Medical College, Kangra at Tanda; Himachal Pradesh, India. *[email protected] REFERENCES 1. Bhat CS, Gupta L, Balasubramanian S, Singh S, Ramanan A V. Hyper inflammatory syndrome in children associated with COVID-19: Need for awareness [published online ahead of print, 2020 Jul 15]. Indian Pediatr. 2020; S097475591600208.
Impact of the COVID-19 Pandemic on Retinopathy of Prematurity Practice: An Indian Perspective
during the lockdown. In the pre lockdown period, the number of babies screened in the OPD were significantly higher than those screened inside the institute NICU/neonatal nursery (P=0.001), which was also reversed during the lockdown period. Impact on ROP treatment: Laser photocoagulation was increasingly preferred (49 eyes) over intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents (2 eyes) as the primary treatment during the lockdown period. The main reason for this was the finite nature of laser photocoagulation compared to the risk of recurrences with anti-VEGF agents, which requires regular and extended follow-up [4]. We had at least three babies with aggressive posterior retinopathy of prematurity (APROP) who were given anti-VEGF injection prior to lockdown and missed follow-up for two months owing to movement restrictions during lockdown. While the disease regressed in two of these babies, one progressed to develop tractional retinal detachment in both eyes and required surgical intervention. In the pre-lockdown period, all laser treatments (for outborns as well as inborns) were done inside the neonatal nursery/NICU of our institute under monitoring by a neonatologist. This sometimes entailed a wait period of 24-48 hours depending on availability of a monitoring bed in the NICU. During the lockdown, there was shut down of most elective procedures such as cataract surgery. This allowed availability of more operation theatre (OT) tables for emer-gency procedures. We therefore arranged to perform all ROP interventions in the OT itself with the focus being on same day treatment. A pediatrician was available on call for mon
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