Changing clinical patterns of Rhegmatogeneous Retinal Detachments during the COVID19 pandemic lockdown in the North West of the UK

Jasani, Kirti M; Ivanova, Tsveta; Sabatino, Francesco; Patton, Niall; Dhawahir-Scala, Felipe; Chew, Grace; Charles, Stephen; David, Philip; Davies, Andrew; Jalil, Assad

doi:10.1177/1120672120965480

Cited by 12 publications

(21 citation statements)

References 14 publications

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“…11 This might be partly due to our facility being the only tertiary care unit offering the services of urgent retinal surgeries in our region during this unprecedented time. This increase is in contrast to a 62% decline reported in UK in a recent analysis as well as two other studies conducted recently 10,12,13 . Among the key features of RRD; more macular off status was observed during LP in our study that is consistent with previous studies.…”

Section: A H E a D O F P R I N Tcontrasting

confidence: 85%

Impact of COVID-19 lockdown on Retinal Surgeries

2021

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Objectives: To determine the frequency and severity of surgical Vitreo-Retinal diseases during COVID-19 lockdown period (LP) and compare it with same period last year. Methods: Single hospital based retrospective Cohort Study. Data of the patients that underwent retinal surgeries during the COVID-19 LP i.e., 23-03-2020 till 23-06-2020 and same period last year i.e., 23-03-2019 till 23-06-2019 was analyzed. Results: One hundred thirty-six eyes of 105 patients were included. Among these eyes, 48 (35.3%) were operated during the COVID-19 LP while 88 (64.7%) were operated during the same time last year. A decline of 45.5% (p=0.023) was observed in the frequency of surgeries during the LP. Mean age of patients during the LP was 43.2 ± 20.3 years compared to 48.4 ± 17.9 years last year. There was reduction in the surgeries for Diabetic Tractional Retinal Detachment (11.4% vs 4.2% during LP, p=0.166), Vitreous hemorrhage (10.2% vs 8.3% during LP, p=0.04), Full thickness macular hole (3.4% vs 0% during LP) and Epiretinal membrane (12.5% vs 0% during LP). While Rhegmatogenous retinal detachment (27.3% vs 58.3% during LP, p<0.001) among other disorders had a higher proportion during the LP. Conclusion: The decline in the frequency of retinal surgeries during the LP is indicative of complex pathologies presenting later with more advanced disease. However, earlier presentation and an increase trend in surgeries for RRD during the LP shows the positive impact of free time on the health concerns of our population. doi: https://doi.org/10.12669/pjms.37.7.4291 How to cite this:Awan MA, Shaheen F, Mohsin F. Impact of COVID-19 lockdown on Retinal Surgeries. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4291 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: A H E a D O F P R I N Tcontrasting

confidence: 85%

Impact of COVID-19 lockdown on Retinal Surgeries

2021

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“…A group from the UK found evidence for more progressed retinal detachments (characterized by a higher rate of macula-off situations and PVR) during the pandemic compared to pre pandemic levels (13). In the presented study, patients did not report a delayed treatment, as reported above.…”

Section: Discussionsupporting

confidence: 65%

Emergency treatment of ophthalmologic diseases during the first phase of SARS-CoV2 pandemic in a tertiary referral center in Germany – the COVID-DETOUR questionnaire study

Ehlken

Medem

Lüdemann

et al. 2021

Preprint

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Background:During the first wave of the COVID-19 pandemic, the need of treatment of urgent ophthalmological diseases and the possible risk of a SARS-CoV-2 infection had to be weighed against each other. In this questionnaire study, we aimed to analyze potential barriers and patients’ health beliefs during and after the lockdown early 2020 in a tertiary referral center in Kiel, Germany.Methods:Patients admitted for the treatment of urgent ophthalmic diseases between March 1st, 2020, and June 3rd, 2020, were asked to participate in a questionnaire study. After informed consent was obtained, patients were interviewed using a standardized questionnaire which addressed aspects of their medical history, their health beliefs concerning the COVID-19 pandemic and barriers on their way to the treatment center. The study group was subdivided into two subgroups, depending on the occurrence of their symptoms, before and after the lockdown was ended on April 20th, 2020.Results:Ninety-three patients were included, 43 in subgroup A (before April 20th) and 50 in subgroup B (April 20th or later). Retinal disorders were most common (approximately 60%), with retinal detachments being the most singular reason for admission. Only 8 patients (8.6%) experienced a delay between their decision to visit a doctor until the actual examination. Every fourth patient was afraid of a COVID-19 infection, and expected a higher likelihood for an infection at the hospital. Patients with comorbidities tended to be more likely to be afraid of an infection (correlation coefficient 0.183, p=0.0785) and were significantly more likely to be concerned about problems with organizing follow-up care (corr. coefficient 0.222, p=0.0328). Higher age was negatively correlated with fear of infection (corr. coefficient -0.218, p-value 0.034).Conclusion:In this questionnaire study, only a minority of patients indicated a delay in treatment, regardless of whether symptoms occurred before or after the lockdown before April 20th. While patients with comorbidities were more concerned about infection and problems during follow-up care, patients of higher age – who have a higher mortality – were less afraid. Protection of high-risk groups should be prioritized during the SARS-CoV-2 pandemic.Trial registration:The study was registered as DRKS00021630 at the DRKS (Deutsches Register Klinischer Studien) before the conduction of the study on May 5th, 2020.

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“…A higher prevalence of proliferative vitreoretinopathy related to a longer duration of RRD during the pandemic has been reported previously. 11 , 13 , 14 , 34 In our analysis, the more frequent occurrence of proliferative vitreoretinopathy was reflected by the higher rate of silicone oil tamponade. An increase in the proportion of RRD surgeries involving silicone oil tamponade was observed both on year-to-year comparison and during the second and third waves of the pandemic, implying a delay in the referrals due to RRD.…”

Section: Discussionmentioning

confidence: 51%

“…However, similar to previous studies, we did not find significant differences in the age and sex distribution of patients admitted during the pandemic and a year earlier. 13 , 14 , 22 , 34 …”

Section: Discussionmentioning

confidence: 99%

“…This observation stays in opposition to the results of previous studies in which the COVID-19 pandemic contributed to a various-degree increase in the prevalence of macula-off RRD in various countries. 11,13,14,16,17,34 Importantly, however, those studies covered shorter periods. According to Kaupke et al 22 the number of referrals due to macula-off RRD at a German ophthalmology department remained unchanged during the pandemic, which is consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre

Dmuchowska¹,

Cwalina²,

Krasnicki³

et al. 2021

OPTH

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Purpose This study assessed the effect of three waves of the COVID-19 pandemic primarily on the number and timing of referrals due to rhegmatogenous retinal detachment (RRD) and secondarily on the demographic or clinical characteristics of patients. Patients and Methods A retrospective single-centre analysis of medical records included 247 eyes from 247 patients who underwent primary RRD repair with (phaco) vitrectomy between January 1, 2019, and May 31, 2021. Results The percentage of referrals due to primary RRD during the first year of pandemic (March 2020–February 2021) was 16.5% (p=0.179) lower than a year earlier. The percentage of referrals during the first, second and third wave of the pandemic was 48.4%, 18.5% and 26.1% (p=0.029, 0.475, 0.343) lower than in the corresponding months of 2019. A rebound effect was observed only after the first wave. The numbers of referrals in April and May 2021 were similar as in the corresponding months of 2019. No significant differences were observed in the demographic and clinical characteristics of patients admitted before and during the COVID-19 pandemic, other than a tendency towards a higher representation of women, younger persons, longer duration of symptoms but better visual acuity in the latter group. Silicone oil tamponade was used more frequently during the pandemic than before. Conclusion In this study, the COVID-19 pandemic affected the number and timing of referrals due to RRD and the clinical but not demographic characteristics of the patients. The effect lessened with the duration of the pandemic. Previously raised concerns regarding the delay in RRD referrals may no longer be valid during a potential fourth wave of the pandemic. The impact of the pandemic’s waves should be analysed separately, as such an approach provides a better insight into the fluctuations in the number of referrals due to RRD than a year-to-year comparison.

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Changing clinical patterns of Rhegmatogeneous Retinal Detachments during the COVID19 pandemic lockdown in the North West of the UK

Cited by 12 publications

References 14 publications

Impact of COVID-19 lockdown on Retinal Surgeries

Impact of COVID-19 lockdown on Retinal Surgeries

Emergency treatment of ophthalmologic diseases during the first phase of SARS-CoV2 pandemic in a tertiary referral center in Germany – the COVID-DETOUR questionnaire study

The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre

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