Survey on the management of retinal arterial occlusions in Spain

Abstract

Objective

To determine the current status of retinal artery occlusion (RAO) management in Spain.

Material and Methods

An anonymous questionnaire of 22 questions was carried out on the Google Forms® platform between April 27 and May 28, 2023. This questionnaire was distributed via email by the Spanish Society of Retina and Vitreous and the Spanish Society of Ophthalmology.

Results

159 ophthalmologists from 91 public and 44 private centers in the 17 autonomous communities answered the questionnaire. Fifty-one percent of the ophthalmologists who answered the survey were women, 56.6% worked in public centers, 9.4% in private centers and 34% in both centers. Of the ophthalmologists working in public centers, 41.7% attend ophthalmologic emergencies 24 h a day, 365 days a year, while the rest delay their attention outside the usual hours. In 62.6% of the public centers with responses collected there are no protocols for the management of OAR in the ophthalmology services and as for multidisciplinary protocols, 57% recognize that they do not have one, 23% have one with neurology or internal medicine and only 13% of the centers include OAR within the stroke code. The most frequently reported treatments are hypotensors and anterior chamber paracentesis. In private centers, 73.7% report not having their own protocol, and 78.9% do not have a protocol with other services.

The main barriers perceived by the ophthalmologists surveyed were: patients arriving outside the window period (77.2%), no specific treatment and lack of established protocols (55.4%), low incidence (32.9%). Suggestions for improvement were: need to implement protocols, coordination with other services and that OAR be included as a stroke code.

Conclusions

Despite its limitations, (simple questionnaire, open design of some questions, lack of representation of centers and provinces and contradictory responses within the same center), we consider that it can serve as an approximation to the current management of RAO in Spain. It is necessary to develop protocols adapted to the different centers and to comply with them effectively in order to improve accessibility and equity.