To evaluate the effect of the coronavirus disease 2019 (COVID-19)-related lockdown in the management of patients with diabetic retinopathy (DR), including diabetic macular edema (DME), in a tertiary reference center in Greece.
MethodsIn this retrospective study, we first compared the number of patients who were diagnosed with DR or DME in our clinic during the period of the lockdown and during the same period of the previous year. In addition, we included consecutive patients with DR or DME, who were followed up and treated regularly in our clinic and their appointments deferred due to lockdown, so as to compare the visual acuity, fundoscopy, and optical coherence tomography (OCT) findings prior to and post lockdown.
ResultsDuring the lockdown period, there was a statistically significant decrease in patients with DR and DME as compared to the same period in the previous year. Regarding patients with previously diagnosed DME, there was a statistically significant worsening in their visual acuity and central retinal thickness after lockdown as compared to the last visit before lockdown (p<0.001 for both comparisons). Concerning patients diagnosed with DR and without DME before lockdown, 30% of patients with severe non-proliferative diabetic retinopathy (NDPR) and 8.3% of patients with quiescent proliferative DR (PDR) progressed to active PDR while four out of 107 patients (3.7%) developed DME during the lockdown. Multivariate regression analysis revealed that only the time interval between the last visit before lockdown and the first visit after the lockdown was associated with the best-corrected visual acuity (BCVA) change (p=0.017).
ConclusionsThe COVID-19-related lockdown was related to the postponement in patient care, which resulted in significantly worse visual acuity outcomes in patients with DR.
Purpose: The purpose of this prospective study was to evaluate potential predictive factors of long-term postoperative outcome in patients with macula-off rhegmatogenous retinal detachment (RRD), treated with pars plana vitrectomy (PPV).
Methods: Participants in the study were 86 patients diagnosed with macula-off RRD, who underwent PPV. Demographic characteristics and preoperative characteristics of RRD were recorded, while best corrected visual acuity (BCVA) was measured preoperatively and at specific postoperative time-points (week 6 and months 6, 12 and 24). In addition, spectral domain-optical coherence tomography (SD-OCT) characteristics at postoperative week 6 were assessed as potential factors, affecting the long-term postoperative visual outcome 24 months after PPV for RRD.
Results: Increasing age, duration of RD more than 1 week, presence of proliferative vitreoretinopathy, increasing central retinal thickness, ellipsoid zone disruption and external limiting membrane disruption were significantly associated with worse BVCA. BCVA was not associated with gender, lens status, location of breaks, gas tamponade agent used in PPV, presence of subretinal fluid and intraretinal fluid.
Conclusions: It is important to determine predictive factors for visual outcome, so as to inform patients about prognosis and help in the decision-making of patients’ management.
Introduction
This study evaluated complete blood count-derived inflammation indices in patients with retinal vein occlusion (RVO).
Methods
Participants in this case–control study were 54 patients with RVO and 54 age- and sex-matched control subjects. All participants underwent a thorough ophthalmic examination, as well as blood sample testing for complete blood count. Comparison of all parameters derived from complete blood count as well as calculation of specific indices was performed between patients with RVO and controls.
Results
Patients with RVO presented significantly higher white blood cell count (
p
= 0.033), neutrophil count (
p
= 0.003), neutrophil-to-lymphocyte ratio (NLR,
p
= 0.002), red cell distribution width (RDW,
p
= 0.009), mean platelet volume (MPV,
p
= 0.023), and systemic immune-inflammatory index (SII,
p
= 0.007) compared to controls. Receiver operator characteristic curve (ROC) analysis showed that NLR was superior to other inflammatory indices, having the greatest area under the curve. The optimal cutoff value for NLR to predict RVO was 2.29 with 46.2% sensitivity and 77.8% specificity.
Conclusion
Patients with RVO presented increased NLR, RDW, MPV, and SII, providing evidence that inflammation plays an important role in the pathogenesis of RVO. Complete blood cell count-derived indices can be easily calculated and may serve as an easy, simple, and cost-effective tool to evaluate the degree of systemic inflammation in patients with RVO, so as to potentially guide treatment.
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