Results of a national survey on the management of patients with macular disease

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

doi:10.1016/j.oftale.2017.07.005

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(b) Fluorescein angiography showing leak points at the macular area level. (c) Macular OCT taken with Spectralis OCT Heidelberg® (Heidelberg, Germany), with central foveal thickness of 414microns and associated NSD. Approximate subfoveal choroidal thickness of 200microns (see arrow). (d) Macular OCT taken with Spectralis OCT Heidelberg® (Heidelberg, Germany), with central thickness of 317microns, after spironolactone treatment, showing the same subfoveal choroidal thickness after treatment with spironolactone (see arrow)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Rocha Cabrera, L. Cordovés Dorta, D. Ángel Pereira, J.A. Abreu Reyes, M.J. Losada Castillo, J. Lorenzo Morales, M.Á. Serrano García" "autores" => array:7 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Rocha Cabrera" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Cordovés Dorta" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Ángel Pereira" ] 3 => array:2 [ "nombre" => "J.A." 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"apellidos" => "Serrano García" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S036566911630082X" "doi" => "10.1016/j.oftal.2016.06.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036566911630082X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579416301335?idApp=UINPBA00004N" "url" => "/21735794/0000009200000010/v1_201709270057/S2173579416301335/v1_201709270057/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Results of a national survey on the management of patients with macular disease" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e61" "paginaFinal" => "e62" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. 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"apellidos" => "Dolz-Marco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Unidad de Mácula, Clínica Oftalvist, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital Universitario La Candelaria, Tenerife, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares (Madrid), Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Cirugía, Ciencias Médicas y Sociales, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares (Madrid), Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital Universitario Clínico San Carlos, Madrid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "FISABIO Oftalmología Médica, Valencia, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resultados de una encuesta nacional sobre la gestión de pacientes con enfermedad macular" ] ] "textoCompleto" => "At present, managing consultations of patients with macular disease is a relevant health problem. In this context, in the framework of the Spanish Macula Club, an online survey was sent through the Internet to its members in order to assess the current situation of macular disease assessment in Spanish hospitals. Assuming the well-known limitations of this approach, the survey results appear to be interesting and provide food for thought.Overall, 27 members responded the survey, mostly ophthalmologists with over 5 years experience (51.9%) or ophthalmology residents (29.6%). All regions of Spain were represented in the survey.From the organizational viewpoint, only 48.1% of hospitals have a specific Medical Retina Department operated by 2–3 ophthalmologists (47.4%). In hospitals with a joint Medical-Surgical Retina Department, 57.1% have at least 4 ophthalmologists. Training of potential ophthalmologists for medical retina is of the essence. Usually, residents rotate over 4 months through the medical or medical-surgical retina departments of University hospitals in Spain (81.5%).The essential test for assessing macular disease is optical coherence tomography (OCT).<a class="elsevierStyleCrossRef" href="#bib0020">1</a> It is surprising that 78.8% of the survey indicated that they do not have specific training for OCT image interpretation in the hospitals. This could be equivalent to radiologists not trained in the interpretation of magnetic resonance, for instance. In fact, 51.8% of respondents expressed their dissatisfaction with the level of OCT image interpretation. Generally, this test is carried out by nurses (44.4%) or optometrists (14.8%), although it is not surprising that OCT assessments are indicated only for patients visiting hospitals with suspected macular disease (70.4%). In order to carry out an adequate screening of prevalence of macular diseases, the standardized intraocular pressure assessment in ophthalmology practices would be as necessary as OCT. Even within the retina section, only 74.1% of patients have OCT in all the visits. Tomographic images are mostly interpreted with a viewer (44.4%) or in the tomograph device (40.7%), which is essential for scanning the entire macula region searching for morphometric alterations with pathological significance. In 14.8% of cases, the test is assessed with a printed copy with the ensuing interpretation limitations. Likewise, 70.4% of tomographic analyses are based on the attention of a macular cube, which involves an additional risk due to the limitation of the analysis area.The ophthalmological community has recognized the growing problem of macular disease consultation management, together with the difficulty of obtaining an early diagnostic of the disease and acceptable health results with available treatments.<a class="elsevierStyleCrossRefs" href="#bib0025">2,3</a> Doubtlessly, the next step would be to modify the pre-established care scheme for these patients, which constitute the majority of schemes in ophthalmology departments, and which will be more numerous in parallel with the progressive aging of the population. Action calls for reaction. It is time to react.Conflict of interestsThe authors declare the absence of any conflict of interests related to the subject matter discussed in this letter." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] 1 => array:2 [ "identificador" => "xack302000" "titulo" => "Acknowledgments" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Gallego-Pinazo R, Abreu-González R, López-Guajardo L, Donate-López J, Dolz-Marco R. Resultados de una encuesta nacional sobre la gestión de pacientes con enfermedad macular. Arch Soc Esp Oftalmol. 2017;92:e61–e62." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reduced fluorescein angiography and fundus photography use in the management of neovascular macular degeneration and macular edema during the past decade" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E.W. Schneider" 1 => "P. Mruthyunjaya" 2 => "N. Talwar" 3 => "K. Harris Nwanyanwu" 4 => "B. Nan" 5 => "J.D. Stein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1167/iovs.13-13034" "Revista" => array:6 [ "tituloSerie" => "Invest Ophthalmol Vis Sci" "fecha" => "2014" "volumen" => "55" "paginaInicial" => "542" "paginaFinal" => "549" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24346174" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A retrospective study of the real-life utilization and effectiveness of ranibizumab therapy for neovascular age-related macular degeneration in the UK" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Hykin" 1 => "U. Chakravarthy" 2 => "A. Lotery" 3 => "M. McKibbin" 4 => "J. Napier" 5 => "S. Sivaprasad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/OPTH.S92627" "Revista" => array:6 [ "tituloSerie" => "Clin Ophthalmol" "fecha" => "2016" "volumen" => "10" "paginaInicial" => "87" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26834453" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Age-related macular degeneration: clinical findings following treatment with antiangiogenic drugs" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Casaroli-Marano" 1 => "R. Gallego-Pinazo" 2 => "C.T. Fernández-Blanco" 3 => "M.S. Figueroa" 4 => "B. Pina Marín" 5 => "G. Fernández-Baca Vaca" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2014/346360" "Revista" => array:5 [ "tituloSerie" => "J Ophthalmol" "fecha" => "2014" "volumen" => "2014" "paginaInicial" => "346360" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24693418" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack302000" "titulo" => "Acknowledgments" "texto" => "The authors wish to express their gratitude to all the physicians who took time to respond to the online survey on which this article is based and who, being anonymous, cannot be identified." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009200000010/v1_201709270057/S2173579417301512/v1_201709270057/en/main.assets" "Apartado" => array:4 [ "identificador" => "5813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009200000010/v1_201709270057/S2173579417301512/v1_201709270057/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301512?idApp=UINPBA00004N"]

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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. 92. Issue 10.

Pages e61-e62 (October 2017)

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