Season 1, Episode 3: Dr. Juliana Sallum

In this week’s episode of “In-Focus”, Avril welcomes Professor Juliana Sallum to the podcast. Juliana is an ophthalmologist who specialises in inherited retinal degenerations (IRDs) and genetics and is a professor at the University of Sao Paulo, Brazil. In this podcast, Juliana takes us through the unprecedented challenges that she and her colleagues face as ophthalmologists during COVID-19. She explains that although the current circumstances have resulted in physical consultations being postponed, virtual contact and telemedicine have emerged as key players which allow her to check in with her patients, discuss any concerns they may have and ensure that they can prepare a treatment strategy, once COVID-19 has passed. While many clinics have been temporarily taken over to be used for COVID-19 patients in Brazil and in other parts of the globe, Juliana reassures us that emergency operations, such as retinal detachments are still a priority and will be operated on as necessary. People living with other retinal conditions, including age-related macular degeneration (AMD) and diabetes-related eye diseases (DEDs) who receive anti-VEGF treatment are also being thoroughly assessed remotely, using virtual communication tools to identify those who are stable and others who require more urgent treatment. Although telemedicine and the virtual communication tools used right now to check in with patients are not perfect, Juliana expresses her belief that this style of remote access to care will be a key strategy in the future to ensure more equitable access to quality healthcare, in particular people in the ageing population and will also help to relieve some of the strain on our healthcare systems. Planning for the aftermath of COVID-19 and organising a strategic plan to deal with the long waiting lists of patients to receive treatment is a primary part of Juliana’s work at this time and she believes telemedicine will have a crucial role in facilitating this. Regarding clinical trials, Juliana explains that every effort is being made to accommodate people in clinical trials and adjust the scheduled treatment intervals without disrupting the legitimacy of the trial. First and foremost is patient safety however, and all these clinical trials are re-organised with this as the central focus. This is a really insightful and comprehensive interview in which Juliana addresses many pressing concerns in the retina community, particularly among people living with chronic retinal conditions that require regular treatment and how this is being adjusted in light of COVID-19.