{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:30:36Z","timestamp":1762918236236,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:00:00Z","timestamp":1622246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: During the first COVID-19 pandemic outbreak, a new triage concept had to be implemented for patients with retinal diseases having a scheduled appointment at the medical retina clinic. In this study, we aimed to assess patients\u2019 confidence in this triage concept and patients\u2019 satisfaction regarding the received treatment during the outbreak. Methods: This retrospective study included all patients with a diagnosed retinal disease, triaged into three priority groups based on their condition\u2019s urgency during lockdown. After restrictions were eased, a subset of previously triaged patients was interviewed to assess their confidence in the triage and their satisfaction regarding the received treatment during the pandemic. Results: In total, 743 patients were triaged during the lockdown. Over 80% received an urgent appointment (priority 1). Among all priority 1 patients, over 84% attended their appointment and 77% received an intravitreal injection (IVI), while 7% cancelled their appointment due to COVID-19. In post-lockdown interviews of 254 patients, 90% trusted the emergency regimen and received treatment. Conclusions: Our triage seemed to be useful in optimizing access to treatment for patients with retinal diseases. An excellent rating of patients\u2019 confidence in the triage and satisfaction regarding the received treatment during the first COVID-19 outbreak could be achieved.<\/jats:p>","DOI":"10.3390\/ijerph18115846","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:22:15Z","timestamp":1622420535000},"page":"5846","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Assessment of Patients\u2019 Confidence Regarding a New Triage Concept in a Medical Retina Clinic during the First COVID-19 Outbreak"],"prefix":"10.3390","volume":"18","author":[{"given":"Anahita","family":"Bajka","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Zurich, 8091 Zurich, Switzerland"},{"name":"University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7561-1805","authenticated-orcid":false,"given":"Maximilian Robert Justus","family":"Wiest","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Zurich, 8091 Zurich, Switzerland"},{"name":"University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Hamann","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Zurich, 8091 Zurich, Switzerland"},{"name":"University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7152-2613","authenticated-orcid":false,"given":"Mario Damiano","family":"Toro","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Zurich, 8091 Zurich, Switzerland"},{"name":"University of Zurich, 8006 Zurich, Switzerland"},{"name":"Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7431-1774","authenticated-orcid":false,"given":"Sandrine Anne","family":"Zweifel","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Zurich, 8091 Zurich, Switzerland"},{"name":"University of Zurich, 8006 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e925","DOI":"10.1111\/aos.14469","article-title":"Amd management during the covid-19 pandemic","volume":"98","author":"Colantuono","year":"2020","journal-title":"Acta Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1007\/s00417-020-04955-7","article-title":"Short-term outcomes of patients with neovascular exudative amd: The effect of covid-19 pandemic","volume":"258","author":"Borrelli","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Cummings, A.B., Gildea, C., Br\u00e9zin, A.P., Malyugin, B.E., Evren Kemer, O., Kermani, O., Prieto, I., Rejdak, R., Teus, M.A., and Tognetto, D. (2021). Impact on refractive surgery due to increasing use of personal protection equipment: Insights from eurocovcat group. Eur. J. Ophthalmol.","DOI":"10.1177\/11206721211018641"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1111\/ceo.13855","article-title":"Proof-of-concept calculations to determine the health-adjusted life-year trade-off between intravitreal anti-vegf injections and transmission of covid-19","volume":"48","author":"Boyd","year":"2020","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/1120672120960339","article-title":"Early impact of covid-19 outbreak on eye care: Insights from eurocovcat group","volume":"31","author":"Toro","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2879","DOI":"10.2147\/OPTH.S260960","article-title":"Early impact of covid-19 outbreak on the availability of cornea donors: Warnings and recommendations","volume":"14","author":"Toro","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1056\/NEJMc2004973","article-title":"Aerosol and surface stability of sars-cov-2 as compared with sars-cov-1","volume":"382","author":"Bushmaker","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1007\/s00417-020-04703-x","article-title":"Guidance for anti-vegf intravitreal injections during the covid-19 pandemic","volume":"258","author":"Korobelnik","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1038\/s41433-020-1061-3","article-title":"Reshaping ophthalmology training after covid-19 pandemic","volume":"34","author":"Ferrara","year":"2020","journal-title":"Eye"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Russo, A., Longo, A., Avitabile, T., Bonfiglio, V., Fallico, M., Boscia, F., Furino, C., Cillino, S., Toro, M., and Rejdak, R. (2019). Incidence and risk factors for tractional macular detachment after anti-vascular endothelial growth factor agent pretreatment before vitrectomy for complicated proliferative diabetic retinopathy. J. Clin. Med., 8.","DOI":"10.3390\/jcm8111960"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Nguyen, V., Barthelmes, D., and Gillies, M.C. (2021). Neovascular age-related macular degeneration: A review of findings from the real-world fight retinal blindness! Registry. Clin. Exp. Ophthalmol.","DOI":"10.1111\/ceo.13949"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e000749","DOI":"10.1136\/bmjophth-2021-000749","article-title":"Comparing vision and macular thickness in neovascular age-related macular degeneration, diabetic macular oedema and retinal vein occlusion patients treated with intravitreal antivascular endothelial growth factor injections in clinical practice","volume":"6","author":"Gurung","year":"2021","journal-title":"BMJ Open Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1097\/IAE.0b013e31827b6324","article-title":"Changes in visual acuity in patients with wet age-related macular degeneration treated with intravitreal ranibizumab in daily clinical practice: The lumiere study","volume":"33","author":"Cohen","year":"2013","journal-title":"Retina"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1136\/bjophthalmol-2014-305327","article-title":"Multi-country real-life experience of anti-vascular endothelial growth factor therapy for wet age-related macular degeneration","volume":"99","author":"Holz","year":"2015","journal-title":"Br. J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Tognetto, D., Brezin, A.P., Cummings, A.B., Malyugin, B.E., Evren Kemer, O., Prieto, I., Rejdak, R., Teus, M.A., Tornblom, R., and Toro, M.D. (2020). Rethinking elective cataract surgery diagnostics, assessments, and tools after the covid-19 pandemic experience and beyond: Insights from the eurocovcat group. Diagnostics, 10.","DOI":"10.3390\/diagnostics10121035"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"661","DOI":"10.2147\/OPTH.S289068","article-title":"Delayed intravitreal anti-vegf therapy for patients with macular edema during the covid-19 lockdown, an ethical endeavor","volume":"15","author":"Elfalah","year":"2020","journal-title":"Clin. Ophthal."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e000560","DOI":"10.1136\/bmjophth-2020-000560","article-title":"Remodelling intravitreal therapy pathways for macular disease during the covid-19 pandemic and an austrian national lockdown","volume":"5","author":"Huemer","year":"2020","journal-title":"BMJ Open Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.ajo.2006.06.058","article-title":"Age-related macular degeneration is associated with an increased risk of hip fractures in the medicare database","volume":"142","author":"Anastasopoulos","year":"2006","journal-title":"Am. J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.1007\/s00417-020-04849-8","article-title":"Macula service evaluation and assessing priorities for anti-vegf treatment in the light of covid-19","volume":"258","author":"Stone","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1001\/jamaophthalmol.2019.1085","article-title":"Longitudinal associations of self-reported vision impairment with symptoms of anxiety and depression among older adults in the united states","volume":"137","author":"Frank","year":"2019","journal-title":"JAMA Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1007\/s12603-016-0768-0","article-title":"Does visual impairment affect social ties in late life? Findings of a multicenter prospective cohort study in germany","volume":"21","author":"Hajek","year":"2017","journal-title":"J. Nutr. Health Aging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1038\/s41433-020-0925-x","article-title":"Current safety preferences for intravitreal injection during covid-19 pandemic","volume":"34","author":"Shmueli","year":"2020","journal-title":"Eye"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1007\/s00417-020-04693-w","article-title":"Treating neovascular age-related macular degeneration in the era of covid-19","volume":"258","author":"Antaki","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1001\/jamaophthalmol.2019.6035","article-title":"Assessment of the drcr retina network approach to management with initial observation for eyes with center-involved diabetic macular edema and good visual acuity: A secondary analysis of a randomized clinical trial","volume":"138","author":"Glassman","year":"2020","journal-title":"JAMA Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s40135-013-0019-z","article-title":"Oct in the management of diabetic macular edema","volume":"1","author":"Waheed","year":"2013","journal-title":"Curr. Ophthalmol. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1016\/j.ophtha.2013.11.041","article-title":"Three-year outcomes of individualized ranibizumab treatment in patients with diabetic macular edema: The restore extension study","volume":"121","author":"Lang","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jaci.2020.04.006","article-title":"Risk factors for severity and mortality in adult covid-19 inpatients in wuhan","volume":"146","author":"Li","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.dsx.2020.04.004","article-title":"Diabetes in covid-19: Prevalence, pathophysiology, prognosis and practical considerations","volume":"14","author":"Singh","year":"2020","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/j.0011-7315.2004.02570.x","article-title":"The role of clinical and process quality in achieving patient satisfaction in hospitals","volume":"35","author":"Marley","year":"2004","journal-title":"Decis. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1007\/s00417-020-04697-6","article-title":"Communicating with patients with namd and their families during the covid-19 pandemic","volume":"258","author":"Korobelnik","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_31","first-page":"893","article-title":"Instruments to assess patient satisfaction after teleconsultation and triage: A systematic review","volume":"8","author":"Kunz","year":"2014","journal-title":"Patient Prefer. Adherence"},{"key":"ref_32","first-page":"1","article-title":"The impact of covid-19 on intravitreal injection compliance","volume":"Oct28","author":"Wasser","year":"2020","journal-title":"SN Compr. Clin. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Boyd, M.J. (2020). How urgent do intravitreal anti-vegf injections need to be to justify the risk of transmitting covid-19? Proof-of-concept calculations to determine the health adjusted life-year (haly) trade-off. Clin. Exp. Ophthalmol.","DOI":"10.1101\/2020.04.27.20075085"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Dolar-Szczasny, J., Toro, M.D., Dworzanska, A., Wojtowicz, T., Korona-Glowniak, I., Sawicki, R., Boguszewska, A., Polz-Dacewicz, M., Tomasiewicz, K., and Zaluska, W. (2021). Ocular involvement of sars-cov-2 in a polish cohort of covid-19-positive patients. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18062916"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s11739-010-0362-0","article-title":"Triage in public health emergencies: Ethical issues","volume":"5","author":"Petrini","year":"2010","journal-title":"Intern Emerg. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1136\/medethics-2020-106457","article-title":"Triage and justice in an unjust pandemic: Ethical allocation of scarce medical resources in the setting of racial and socioeconomic disparities","volume":"47","author":"Tolchin","year":"2020","journal-title":"J. Med. Ethics"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/5846\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:10:29Z","timestamp":1760163029000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/5846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,29]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["ijerph18115846"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18115846","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2021,5,29]]}}}