AimTo identify retinal findings using dilated eye examination, which are possibly related to SARS-CoV-2 infection in hospitalised patients with confirmed severe COVID-19.MethodsIn this cross-sectional study, hospitalised patients with confirmed severe COVID-19 in a single referral centre for the treatment of COVID-19, in Santo André, São Paulo Metropolitan Area, Brazil, underwent dilated eye examination of both eyes performed by a retina specialist. Findings were recorded using a portable digital fundus camera. Retinographies were analysed by two retina specialists. Medical records were reviewed for assessment of patient demographics, baseline comorbidities and clinical data.ResultsThere were a total of 18 patients, nine (50%) male, median IQR age of 62.5 (12) years. Ten of the 18 patients (55.6%; 95% CI 33.7 to 75.4) had abnormalities on dilated eye examination. The main findings were flame-shaped haemorrhages (N=4; 22.2%; 95% CI 9.0 to 45.2) and ischaemic pattern lesions (cotton wool spots and retinal sectorial pallor) (N=4; 22.2%; 95% CI 9.0 to 45.2), with one patient having both cotton wool spots and flame-shaped haemorrhages.ConclusionThese findings suggest that patients with severe COVID-19 have acute vascular lesions of the inner retina including flame-shaped haemorrhages and cotton wool spots. Further studies controlling for confounding factors are necessary to properly assess these findings so as to increase the understanding of COVID-19 pathophysiology and to identify new therapies.

ObjectivesTo evaluate athletes’ frequency of attendance at the eye clinic during the Olympic and Paralympic Games Rio 2016 and to correlate it to WHO core indicators on progress in ophthalmology care in a country.MethodsFrequencies of athletes’ attendance at the eye clinic were calculated for each country. Countries were classified according to the World Bank income levels in high, upper-middle, low-middle or low-income country. Data on ophthalmology care for each country were derived from the International Agency for the Prevention of Blindness atlas. Data were analysed in view of WHO indicators for each country: visual impairment prevalence considering presenting visual acuity <6/18 to ≥3/60 in the better vision eye; number of ophthalmologists per million people and the cataract surgical rate per year, per million population.ResultsThe athletes’ overall frequency of attendance in the eye clinic was 6.47%. Frequencies of attendance for high, upper-middle, low-middle or low-income country were 1.97%, 9.66%, 16.54% and 22.43%, respectively. A positive correlation was observed between the athletes’ attendance frequency of a country and its visual impairment prevalence (r=0.2290, p=0.0017). A negative correlation was observed between the athletes’ attendance frequency of a country and its eye health workforce (r=−0.2152, p=0.0026).ConclusionCountries with highest athletes’ frequencies of attendance were those that face barriers to eye care provision. These results reinforce the importance of the eye clinic service during the Olympic and Paralympic Games proving access to specialised care to athletes and members of delegation.

ObjectivesTo describe the attendance and ocular profile of competitors and members of delegations who attended the Polyclinic Ophthalmology Division during the Olympic and Paralympic Games Rio 2016.MethodsThe eye clinic was allocated in the purpose-built polyclinic opened for competitors and members of delegations from 24 July to 18 September 2016. All individuals who attended the service received a comprehensive ocular examination including biomicroscopy, subjective refraction and fundus evaluation. A main clinical finding was assigned for each eye by the ophthalmologist.Results5.6% of Olympic Games competitors and 8.9% of Paralympic Games competitors attended the Polyclinic Ophthalmology Division during the Rio Olympic and Paralympic Games. These rates compare with 2.6% and 6.5% at the London Olympic and Paralympic Games (2012). The main clinical finding was refractive error with 79.0% of the individuals receiving a glass prescription during the Olympic Games and 81.3% during the Paralympic Games.ConclusionOur outcomes highlight the importance of the eye service at the polyclinic as it may represent the only opportunity for many individuals involved with the Olympic and Paralympic Games to receive ocular evaluation. Our description of clinic structure, delivery of service and clinical results will be useful in the organisation not only for the Olympic and Paralympic Games Tokyo 2020 but also for any other large sporting events that involves medical attention in a polyclinic format.

Introduction: With the arrival of the SARS-CoV-2 (Coronavirus 2 of severe acute respiratory syndrome) pandemic in Brazil, especially in the city of São Paulo, there was a need to apply social isolation policies associated with testing, covering all municipalities. The Clinical Analysis Laboratory of Centro Universitário FMABC was one of the first laboratories to receive certification and qualification to perform RT-PCR (reverse transcriptase reaction followed by polymerase chain reaction) tests in the metropolitan region of São Paulo. Objective: Aim to analyze the influence of adopting social isolation on the incidence of positivity in COVID-19 tests in the metropolitan region of São Paulo, Brazil. Methods: a descriptive study carried out from March to May 2020, epidemiological data were collected from each unit served and organized by the data controllership team of the Clinical Analysis Laboratory of FMABC. Epidemiological, demographic, and laboratory data were extracted from the Matrix® outpatient data management system. Clinically suspected cases and confirmed by laboratory tests (RT-PCR and serological tests) were entered. The tests were divided into serological tests using the RT-PCR molecular test, on samples of nasopharyngeal mucosal scrapings collected with sterile Swab. Results: It were evaluated PCR test and antibody presence (IgA, IgM and IgG) in blood samples of 16.297 patients. 22.718 tests were performed for the diagnosis of COVID-19, both RT-PCR (10.410 tests) and serological tests to detect anti-SARS-CoV-2 antibodies, IgA, IgM and IgG, a total of 16.297 patients were assessed, 63% women and 37% men. It was observed that the social isolation policies adopted during this period contained the massive expansion of contamination, at least while the social isolation rates were above 55%. Conclusion: The data of this study demonstrated the effectiveness of social isolation in containing the positive contamination of SARS-CoV-2 in the metropolitan region of São Paulo, at least for the first three months.

Diabetic Macular Edema is a major cause of visual impairment in economically active population, being responsible for a significant impact in quality of life in the affected population, as well as high costs to the health care system. Over decades, some studies have compared treatments using Laser, Anti-VEGF and intravitreous corticosteroids, establishing protocols to reach effectives therapies. Thus, it is essential an entire understanding of available therapies to reach the goal of disease control, in an individual basis and in a collective health care system, as efficient as possible.