Is it time to adapt to the sub-specialised model in ophthalmology?

Gallego-Pinazo, R.; Dolz-Marco, R.; Donate-López, J.; López-Guajardo, L.; Abreu-González, R.

doi:10.1016/j.oftale.2016.06.002

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"apellidos" => "Abreu-González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Servicio de Oftalmología, Unidad de Mácula, Hospital Universitario y Politécnico La Fe, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Red Temática de Investigación Cooperativa OFTARED, Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Universitario Clínico San Carlos, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Oftalmología, Sección de Retina, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Departamento de Cirugía, Ciencias Médicas y Sociales, Facultad de Medicina, Universidad de Alcalá, Madrid, Alcalá de Henares, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Servicio de Oftalmología, Sección de Retina, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Es el momento de adaptar el modelo de asistencia subespecializada en oftalmología?" ] ] "textoCompleto" => "Changes and transitions in health management models tend to be complicated due to the comfortable and conservative nature of their members. Even so, on some occasions changes are loudly demanded by ophthalmologists and medical managers as well as by patients.In ophthalmology, evolution is advancing at a rapid pace. I hope readers can accommodate my professional bias and focus on the subspecialty of retina. In 2006, with the advent of antiangiogenic medication, treatment for the most prevalent macular diseases finally developed from being palliative to actually curing. However, this treatment requires a well-defined dosage and follow-up strategy, and any random modification thereof is systematically in detriment of the vision of patients. On the other hand, retina surgery has been optimized with new instruments and supporting tools that allow us to approach previously incurable cases with guaranteed success. However, beyond the area of retina surgery, we all know the management problems brought about by the treatment of macular and retina medical disease.Despite said evolution, many reference hospitals maintain “macroscopic” departments established many years ago, like the “macroscopic” retina Dept. even though they are very far from current treatment approaches. In order to ensure effective and efficient care to patients with subsidiary retinal diseases with intravitreous treatments it is necessary to have qualified medical staff. This involves setting up a specific unit. Moreover, even within a macular disease unit, care and treatment procedures are different for age-related macular degeneration, diabetes, myopia or venous occlusions. Accordingly, a “super-specialization”, which is an aspiration of diagnostic and therapeutic means, would enable said units to become independent training and functional units. In addition, this would enhance interaction with other specialties, promoting the creation of multidisciplinary units. Is it far-fetched to bring in a psychologist to support age-related macular degeneration patients? Or to engage an optometrist specialized in poor vision?Reality has to be accepted. And the reality is that we are NOT able to approach the management of patients with MEDICAL macular and retinal diseases. Accepting this reality is the first step, which should be followed by an essential modification of the current management and structure of ophthalmology departments. Otherwise, when treatments for geographic atrophy begin to appear, it is likely that the bubble will burst and, one more time, we will be in the midst of it. It is always a good time to improve because, the way we work nowadays in accordance with clinical practice studies, patients simply do not benefit from the results of their treatments. Their vision deteriorates and quality of life goes down with it. This is not fair and is avoidable. We can and we must resolve this problem.Conflict of interestsNo conflict of interests was declared by the authors." "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Gallego-Pinazo R, Dolz-Marco R, Donate-López J, López-Guajardo L, Abreu-González R. ¿Es el momento de adaptar el modelo de asistencia subespecializada en oftalmología? 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ISSN: 2173-5794
e-ISSN: 1989-7286

Archivos de la Sociedad Española de Oftalmología is the official journal of the Ophthalmology Society of Spain, that has over 4,000 members. It gives priority to the publication of basic, translational and clinic research including reviews, original articles, short communications, editorials, letters to the editor and clinic practice guides related to Ophthalmology and its subspecialties. A small section of the journal is reserved for the most relevant papers presented at the annual Congress of the Society. All manuscripts considered for publication are reviewed by expert examiner peers (double blind). The journal is published monthly and even though its official language is Spanish all articles are translated into English to increase the dissemination of scientific information. At present, Archivos is the only Spanish language Ophthalmology journal indexed in PubMed/MEDLINE in addition to other prestigious international databases such as Scopus.

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Vol. 91. Issue 10.