Impact of Digital Technology on Eye Diseases During COVID-19 : The Asia-Pacific Journal of Ophthalmology

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Editorial

Impact of Digital Technology on Eye Diseases During COVID-19

Wan, Kelvin H. MBChB, FCOphthHK*,†; Jonas, Jost B. MD‡,§

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Asia-Pacific Journal of Ophthalmology: September/October 2022 - Volume 11 - Issue 5 - p 401-402
doi: 10.1097/APO.0000000000000560
  • Open

Health care systems throughout the world have undergone tremendous restructuring to cope with the higher volume of morbidity and hospitalization caused by coronavirus disease 2019 (COVID-19). Significant restructuring is also noted among medical journals when Clarivate released its 2021 journal impact factor. Lancet has taken over the top place in the general and internal medicine category, surpassing the New England Journal of Medicine for the first time since Clarivate first released its citation report 45 years ago. Lancet’s impact increased by more than double—from 79.3 in last year’s report to 202.7 this year. Three of the top 10 most-cited papers of 2021 were published in Lancet, and all of them were on COVID-19.

COVID-19 has made a significant impact on publishing within the ophthalmic community. Thirteen of the 20 most-cited articles among ophthalmology journals are related to COVID-19. Our understanding of the novel coronavirus and its relationship with ophthalmology has come a long way over the past 2 years: from understanding its mode of transmission, to precautionary measures, to its ocular manifestations during the acute phase, and now more recently its features among long-COVID individuals.1–5 In this issue of the Asia-Pacific Journal of Ophthalmology, Ong et al6 reviewed the role of telemedicine and self-monitoring technology among patients with retinal diseases, while Li et al7 conducted a systematic review and meta-analysis regarding the impact of COVID-19 on myopia.

The pandemic has negatively affected our ability to look after our patients. Mobile technologies allow patients with retinal diseases to screen, monitor, and test visual acuity at home. More recently, a patient self-operated optical coherence tomography (OCT) system was evaluated among 15 patients over 3 months. The agreement on the fluid status between the scans automatically graded using software on the self-operated OCT and retinal specialists was over 80% among the scans. As compared to an office-based OCT, they agreed on the presence or absence of fluid in 96% of the cases.8 Home-based OCT has the potential to facilitate earlier detection of disease progression of dry to wet age-related macular degeneration and disease monitoring. Despite the increase in telemedicine uptake during the pandemic, there were inequality and disparities among different specialties of medicine between those who had access to telemedicine. Ethnicity, age, and educational level were associated with access to ophthalmic telemedical care during COVID-19. Certain ophthalmic subspecialties, such as vision rehabilitation and neuro-ophthalmology, had a higher proportion of patients attending telemedicine visits, whereas retinal diseases had the lowest proportion of telemedicine consultations.9 Strategies discussed by Ong and colleagues in this issue will provide some insights on how to overcome these barriers.

Currently, 23% of the world population is myopic, and its prevalence has been estimated to reach nearly 50% by 2050.10 Myopia is a complex multifactorial disorder. The onset and progression of myopia are influenced by many genetic, social, and environmental factors. In particular, the reduction of outdoor times due to lockdown and social distancing measures, increased screen time and near-work as a result of online learning and closure of schools could all play a role in myopia development and progression. During the pandemic, the proportion of grade 3 students without myopia but who are at risk of developing myopia also increased from 31.1% to 49.0% in one study.11 A previous study suggested that during the pandemic, myopic children also had significantly lower daily light exposure and demonstrated less physical activity.12 Moreover, these behavior changes may persist beyond the pandemic duration, heightening the risk of myopic development and progression. In this issue’s meta-analysis, Li et al7 reported a faster myopic shift by –0.73 D per year from the pool estimates of 5 studies during the pandemic as compared with prepandemic period. As the pandemic is still ongoing with the emergence of new virus variants, only time can reveal the long-term impact and corresponding preventive strategies on myopia development and progression.

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Copyright © 2022 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology.