Encuesta sobre el manejo de las oclusiones arteriales retinianas en España

Abstract

Objective

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

Material and methods

We conducted an anonymous 22-question survey questionnaire on Google Forms® from April 27^th through May 28^th, 2023. This survey was distributed by e-mail by the Spanish Vitreo-Retinal Society and the Spanish Society of Ophthalmology.

Results

A total of 159 ophthalmologists from 91 public and 44 private centers across the 17 autonomous communities answered the survey. A total of 5% of respondents were women, 56.6% worked in public centers, 9.4% in private centers and 34% in both centers.

A total of 41.7% of the ophthalmologists working in public centers were also in charge of eye emergencies on a 24-h basis, 365 days/year, while the rest delay the management of these emergencies outside their working hours. In 62.6% of the public centers with responses collected there are no protocols for the management of RAO in the ophthalmology services and as for multidisciplinary protocols, 57% recognize that they do not have one, 23% have one along with neurology or internal medicine and only 13% of the centers include RAO as parte of their stroke code. The most widely reported therapies are hypotensive drugs and anterior chamber paracentesis.

A total of 73.7% of private centers reported not having their own protocol, and 78.9% not having any protocol with any other services. The main barriers perceived by the respondents were patients arriving outside the window period (77.2%), no specific treatment and lack of established protocols (55.4%), and a low incidence rate (32.9%).

Suggestions for improvement were the need for implementing the protocols, coordination with other services and that RAO should be included as part of their stroke code.

Conclusions

Despite its limitations (simple questionnaire, open design of some questions, no center and provincial representation, and contradictory responses within the same center), the survey can serve as an approximation to the current management of RAO in Spain. Protocols adapted to the different centers need to be developed and, then, followed effectively to improve accessibility and equity.