Clinical presentation of acute primary angle closure during the COVID-19 epidemic lockdown

Abstract

PurposeThis study aimed to investigate the clinical presentation of acute primary angle closure (APAC) during the COVID-19 epidemic lockdown in Wuhan.MethodsConsecutive patients seeking APAC treatment at the Wuhan Aier Eye Hospital during the 76 days (January 23–April 8, 2020) when the lockdown policy was implemented due to the COVID-19 pandemic were compared to those during the same period the following year (January 23–April 8, 2021), when the lockdown policy was not implemented. The cohorts were compared to assess demographic variables and clinical presentations.ResultsA total of 54 patients (64 eyes) were included in the 2020, compared with 46 patients (51 eyes) in the 2021. Demographic factors were similar between the groups. Significantly more patients developed blindness in the 2020 cohort (21.87%) than in the 2021 cohort (7.84%). Patients in the 2020 showed a longer time from symptom to treatment (241.84 ± 211.95 h in 2020 vs. 121.53 ± 96.12 h in 2021; P = 0.001), higher intraocular pressure at presentation (52.63 ± 12.45 mmHg in 2020 vs. 45.16 ± 9.79 mmHg in 2021; P = 0.001), larger pupil diameter (5.47 ± 1.62 mm in 2020 vs. 4.33 ± 1.27 mm in 2021; P = 0.001), and more glaucomatous optic neuropathy diagnoses [20/64 eyes (31.25%) in 2020 vs. 7/51 eyes (13.73%) in 2021; P = 0.03].ConclusionThe time between the onset of APAC symptoms and its treatment during the COVID-19 epidemic lockdown was significantly prolonged, which increased the blindness rate of APAC patients.

The Outbreak of Acute Primary Angle-Closure Cases During the COVID-19 Omicron Variant Pandemic at a Tertiary Eye Center in Shanghai

“… 16 During Wuhan’s COVID-19 pandemic from the end of 2019 to the beginning of 2020, a mild increase in the number of APAC cases was observed compared to the next year. 26 Our study showed an obvious outbreak of APAC cases in clinics during the COVID-19 Omicron variant pandemic, which is comparable with a recent report from other hospital in Shanghai and Guangdong. 27 , 28 This may be due to the higher prevalence of PACG among Eskimos, Chinese, and Mongolians.…”

“…Additionally, these data are very similar to those of previous reports in China or Korea in the non-pandemic period. 26 , 35–37 However, the time from symptoms to treatment in the pandemic group was 7.92 ± 6.14 days, which was significantly longer than that in the control group (3.63 ± 2.93 days). In the pandemic group, the time from symptoms to treatment in COVID-19-positive patients was 8.42 ± 6.21 days, which was longer than that in COVID-19-negative patients (6.55 ± 5.76 days).…”

“…These findings are consistent with those of a previous study. 26 Furthermore, the larger pupil diameter in the pandemic group, especially in the COVID-19-positive group, may be due to two reasons. First, the time from symptoms to treatment was longer in the pandemic group, especially in the COVID-19-positive group.…”

Increased incidence of acute primary angle closure during the COVID-19 outbreak in China: A retrospective analysis

“…Zhou et al conducted a comparative analysis of APAC cases during the COVID-19 lockdown period and the corresponding period in the subsequent year. [ 14 ] Their study revealed that during the lockdown, patients experienced a prolonged duration from symptom onset to treatment initiation and presented with elevated IOP. In contrast, our investigation did not identify a significant variation in the disease course between the 2 cohorts.…”

“…While previous case reports and studies have explored the occurrence of APAC attacks during the COVID-19 pandemic, most of them were based on a small number of cases or focused on the clinical characteristics of APAC during lockdown. [12][13][14][15] However, the potential risk factors and clinical characteristics of APAC patients during a COVID-19 outbreak without lockdown remain unexplored. Our investigation assumes that the systemic inflammation and vascular abnormalities associated with COVID-19 may contribute to the pathophysiology of APAC, either by exacerbating preexisting conditions or by initiating new pathogenic processes in the eye.…”