The Impact of COVID-19 Pandemic on Surgical Primary Retinal Detachments

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Abstract

Purpose

This study aimed to describe the impact of COVID-19 pandemic on the presentation characteristics, timings, and surgical decisions for primary rhegmatogenous retinal detachment (RRD).

Methods

A historical cohort including all patients who presented to the Surgical Retina Section at Centro Hospitalar Universitário do Porto (CHUPorto), over a 2-year period, was recruited and divided into 2 groups: pre-COVID and COVID groups. The onset of the COVID-19 pandemic was recorded as starting on March 18, 2020, the same day the first pandemic-related lockdown came to effect in Portugal.

Results

This study enrolled 449 eyes of 443 patients: 272 in the pre-COVID group and 177 in the COVID one. Of the patients, 63.6% were male, and the mean ± SD age was 63.0 ± 13.2 years (range 13–92 years). Of the eyes, 55.5% ( n = 151) presented with macular detachment in the pre-COVID group compared with 66.9% ( n = 119) in the COVID group (odds ratio [OR] 1.62; 95% confidence interval [CI]: 1.09–3.86; p = 0.016). The time from symptom onset to hospital admission ( p = 0.021) and from admission to surgery ( p < 0.001) was longer in the COVID era. In the COVID period, silicone oil (OR 2.03, 95% CI: 1.09–3.79, p = 0.025) and C3F8 gas (OR 2.42, 95% CI: 1.57–3.71, p < 0.001) were used more often. No differences in anatomical success or final visual acuity were found.

Conclusions

The lockdown due to COVID pandemic affected the epidemiology of RRD. The services must adapt to the novel reality and produce backup plans for similar events. Despite the contingencies, the final results were not different between groups.

Related collections

Most cited references 27

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A Novel Coronavirus from Patients with Pneumonia in China, 2019

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Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)

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Resolving the clinical acuity categories "hand motion" and "counting fingers" using the Freiburg Visual Acuity Test (FrACT).

C. Lange, N Feltgen, B. Junker … (2009)

The Freiburg Visual Acuity Test (FrACT) has been suggested as a promising test for quantifying the visual acuity (VA) of patients with very low vision, a condition often classified using the semi-quantitative clinical scale "counting fingers" (CF), "hand motion" (HM), "light perception" (LP) and "no light perception". The present study was designed to assess FrACT performance in a sizable number of CF, HM, and LP patients in order to generate a setting for future clinical studies in the low vision range. We examined a total of 41 patients (LP, n = 11; CF, n = 15; HM, n = 15) with various eye diseases (e.g., diabetic retinopathy, ARMD), covering the clinical VA scale from LP to CF. The FrACT optotypes were presented at a distance of 50 cm on a 17-inch LCD monitor with four random orientations. After training, two FrACT measurements (test and retest) were taken, each comprising 30 trials. FrACT measures reproducibly the VA of CF and HM patients. In CF patients, FrACT resulted in a mean logMAR = 1.98 +/- 0.24 (corresponding to a decimal VA of 0.010), for HM in a mean logMAR = 2.28 +/- 0.15 (corresponding to a decimal VA of 0.0052). In all LP patients the FrACT values were close to what would be obtained by random guessing. The mean test-retest 95% confidence interval was 0.21 logMAR for CF patients and 0.31 logMAR for HM respectively. Test-retest variability declined from 24 to 30 trials, showing that at least 30 trials are necessary. FrACT can reproducibly quantify VA in the CF and HM range. We observed a floor effect for LP, and it was not quantifiable further. Quantitative VA measures are thus obtainable in the very low-vision range using FrACT.

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Proper method for calculating average visual acuity.

J Holladay (2015)

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Author and article information

Journal

Journal ID (nlm-ta): Ophthalmologica

Journal ID (iso-abbrev): Ophthalmologica

Journal ID (publisher-id): OPH

Title: Ophthalmologica. International Journal of Ophthalmology

Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )

ISSN (Print): 0030-3755

ISSN (Electronic): 1423-0267

Publication date (Electronic): 21 October 2021

Publication date PMC-release: 21 October 2021

Pages: 1-6

Affiliations

[1] ^aService of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal

[2] ^bUnit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, Portugal

[3] ^cDepartment of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal

Author notes

*André Ferreira, andre.ferreira@ 123456live.com.pt

Article

Publisher ID: oph-0001

DOI: 10.1159/000520342

PMC ID: 8678219

PubMed ID: 34673635

SO-VID: 37ccf479-3aff-4f2d-85dc-9bdf7ea51bd3

License:

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

History

Date received : 22 July 2021

Date accepted : 19 October 2021

Page count

Tables: 2, References: 24, Pages: 6

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