Guest Editorial

Vitreoretinal care and the pandemic

Our July Retina issue was conceived one month prior to the COVID-19 pandemic and long before the tragic events in Minneapolis. It was targeted to best vitreoretinal practices in our banner year, 2020. Unfortunately, reality struck soon after and directly impacted several of our feature articles. Fortunately, the authors exhibited amazing focus, leadership and grit in bringing their articles to light within the crazy milieu that we have lived through for the past several months.


Drs. Kyle D. Kovacs, Luis A. Gonzalez, M. Abdallah Mahrous and Szilárd Kíss, in the hot zone of New York City, discuss telemedicine for retina patients. This topic, using various technology platforms, has led to rapid shifts in retinal care. Telemedicine approaches have typically focused on non-mydriatic widefield fundus imaging coupled with SD/SS-OCT, allowing the patient to have a rapid imaging assessment. In other cases, we have used virtual examinations to review and discuss the findings with a focus on management (for many patients, minimizing examination time and avoiding the need for in-person physician consultation).

Victor M. Villegas, MD, and I focus on maximizing office efficiencies — a topic that Dr. Villegas has reported on extensively. This article underwent fundamental changes in the post-pandemic world as COVID-19 impacted our clinic flows. This led to multiple novel strategies for patient and staff safety, including virtual waiting rooms, patient and staff personal protective equipment, cleaning standards and social distancing.

David F. Williams, MD, MBA, brings a focus on retina specialty care and the unique abilities of the fellowship-trained retina specialists to deliver best care. Dr. Williams clearly outlines why non-retina specialists should not perform intravitreal injections.

In the realms of imaging and surgery, Jonathan F. Russell, MD, PhD, and Audina M. Berrocal, MD, discuss the current state of adult and pediatric retinal imaging and the importance of technologies such as ultra-widefield fundus and fluorescein angiography in documenting retinal disease. This article further focuses on using these technologies to guide both immediate and future treatments.

This ties nicely to our discussion of advances for diabetic retinopathy surveillance. Charles C. Wykoff, MD, PhD, and Hannah J. Yu, BS, focus on the incorporation of advanced imaging for both individualized patient risk assessment and targeted, patient-specific treatment.

Akshay S. Thomas, MD, MS, and Carl C. Awh, MD, give an overview of current surgical technologies. In addition, they offer a hint at future directions for surgical platforms and advanced imaging.

Finally, Thomas A. Ciulla, MD, MBA, and Michael Gemayel, MD, extend their discussion of gene therapy from a prior article in Ophthalmology Management. They highlight structures for gene therapy, optimization of viral vectors and alternatives to viral vector for delivery and evolving strategies for tissue-specific delivery.


The pandemic has not lessened our focus on best patient care practices, nor has it diminished our passion for improving our care practices through office management, enhanced imaging and targeted therapies. This issue of Ophthalmology Management explores 2020 from the optic of our “new normal,” but with significant hope that this pandemic will crystallize our appreciation of our specialty as true “front-line caregivers.” OM