July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Scope of Retinal Disease-Related Inpatient Ophthalmology Consultations at a National Cancer Institute Designated Comprehensive Cancer Center.
Author Affiliations & Notes
  • M. Ali Khan
    Ophthalmology, Doheny Eye Institute / UCLA, Pasadena, California, United States
  • Philip P. Le
    Ophthalmology, Doheny Eye Institute / UCLA, Pasadena, California, United States
  • Alex Huang
    Ophthalmology, Doheny Eye Institute / UCLA, Pasadena, California, United States
  • Olivia L Lee
    Ophthalmology, Doheny Eye Institute / UCLA, Pasadena, California, United States
  • John A Irvine
    Ophthalmology, Doheny Eye Institute / UCLA, Pasadena, California, United States
  • Footnotes
    Commercial Relationships   M. Ali Khan, None; Philip Le, None; Alex Huang, None; Olivia Lee, None; John Irvine, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 711. doi:https://doi.org/
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      M. Ali Khan, Philip P. Le, Alex Huang, Olivia L Lee, John A Irvine; Scope of Retinal Disease-Related Inpatient Ophthalmology Consultations at a National Cancer Institute Designated Comprehensive Cancer Center.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):711. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe the spectrum of retinal disease-related inpatient ophthalmology consultations at a quaternary care, National Cancer Institute (NCI)-designated Comprehensive Cancer Center.

Methods : Retrospective review of all inpatient ophthalmology consultations at City of Hope Cancer Center (Duarte, CA) from January 2016 – January 2018. City of Hope Cancer Center is one of 49 NCI-designated Comprehensive Cancer Centers in the United States. Billing data from inpatient ophthalmology consultations were extracted and ICD-10 diagnosis codes, visit codes, and procedural codes were analyzed.

Results : A total of 222 inpatient consultation visits on 153 unique patients were completed over the two-year study period, all of which were performed by attending ophthalmologists. Of the initial, new patient consultations, 58/153 (38%) either carried a retinal disease as the primary visit diagnosis or were completed to rule out a retinal diagnosis. The most common indications to rule out retinal disease were fungemia (n=21/58, 36.2%) and CMV viremia (n=8/58, 13.8%). Of patients with a retinal diagnosis on funduscopic examination, the most common diagnoses were: leukemic retinopathy (n=16/58, 27.6%), non-proliferative diabetic retinopathy (n=3/58, 5.2%), and central retinal vein occlusion (n=2/58, 3.4%). The most common concurrent, non-retinal ocular diagnoses were graft-versus host disease and nuclear sclerotic cataract. An acute change in inpatient management, defined as a performed procedure, surgery, additional radiologic study, or escalation in systemic medication, occurred in 6 patients after ophthalmology consultation (n=6/58, 10.3%). A total of 3 patients required inpatient intravitreal pharmacologic injection for the following diagnoses: proliferative diabetic retinopathy with macular edema, fungal endophthalmitis, and HSV-related viral retinitis. One patient with CMV retinitis developed a subsequent rhegmatogenous retinal detachment, requiring outpatient surgery.

Conclusions : Retinal disease-related indications accounted for 38% of all inpatient ophthalmology consultations in the setting of an NCI-designated Comprehensive Cancer Center. Effective consulting and ancillary services, including infectious disease and inpatient pharmacy services, are vital to delivering retinal care in this setting. Telemedicine programs may reduce inpatient consultation burden.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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