Implementation of risk stratification for the care of glaucoma patients during the resumption of in-person care during the COVID-19

ABSTRACT

Introduction: the COVID-19 pandemic sparked a serious health crisis in which non-essential medical services were suspended, with the management of serious diseases not related to the pandemic, including glaucoma, becoming secondary in importance. With the flexibilization of social isolation measures, resuming outpatient care was necessary, respecting the health equity provided by the Brazilian Unified Health System.Objective: to describe a risk classification of glaucoma progression based on clinical ophthalmology criteria during the COVID-19 pandemic.Methods: observational study of an administrative nature. A review was carried out of the medical records of patients who had scheduled appointments between March and September of 2020 in the glaucoma sector of the FMABC University Center's Department of Ophthalmology. A total of 489 medical records (881 eyes) were reviewed, and patients were divided into 4 groups according to the risk of glaucoma progression. Eyes were evaluated for visual acuity (VA), optic disc cup, pachymetry, intraocular pressure (IOP), mean number of eyes drop medications used, and global visual field indexes.Results: groups were homogeneous in terms of age (mean 67.04 ± 11.72 years) and sex (55.5% women and 44.5% men). Primary open-angle glaucoma was the most prevalent etiology, present in 45.2% of patients, followed by primary angle-closure glaucoma in 15.7%. The groups were compared with each other, and a statistical difference (p<0.005) was found in 04 of the 08 aspects analyzed: VA, optic disc cup, IOP and mean number of eyes drop medications used.Conclusion: the risk classification for progression proposed in this study was easily applied and aided managers in prioritizing the most serious care during the COVID-19 pandemic