Impact of COVID-19 lockdown on surgical procedures for retinal detachment in France: a national database study

Abstract

Background/aimsThe COVID-19 crisis and the decisions made regarding population lockdown may have changed patient care. We aimed to investigate the incidence rate of rhegmatogenous retinal detachment (RRD) cases during the COVID-19 lockdown period.MethodsIn this nationwide database study, we identified hospital and clinic admissions of French residents for a first episode of RRD in France from 2017 to the lockdown period in 2020. The monthly hospital incidence rates of RRD procedures per 100 000 inhabitants before, during and after lockdown were computed for the whole country. Finally, we assessed the influence of viral incidence on the RRD incidence rate, comparing two regions with highly contrasting viral penetration.ResultsFrom January to July, the average monthly national hospital incidence rate of RRD decreased from a mean of 2.59/100 000 inhabitants during 2017–2019 to 1.57/100 000 inhabitants in 2020. Compared with 2019, during the 8-week lockdown period in 2020, a 41.6% decrease in the number of RRD procedures was observed (p<0.001) with the weekly incidence of RRD decreasing from 0.63/100 000 inhabitants in 2019 to 0.36/100 000 inhabitants. During the 4-month post-lockdown period, no increased activity related to postponed procedures was observed. No difference was found in the rate of RRD surgery when comparing two regions with highly contrasting viral incidence.ConclusionContainment may have been responsible for a decrease in the number of surgical procedures for RRD, without any compensating post-lockdown activity in France. These results might help increase awareness of the management of RRD emergencies.

First Nation-Wide Study of the Incidence and Characteristics of Retinal Detachment in Poland during 2013–2019

“…Other repair procedures of RD were performed in a small number of patients. However, our study did not cover the period of the COVID 19 pandemic; a decrease in the number of rhegmatogenous RD procedures by 41.6% during the first 8-week lockdown period in 2020 when compared to 2019 was observed in France [ 7 ].…”

“…The most frequent form of RD is rhegmatogenous RD, in which a retinal tear allows liquefied vitreous humor, commonly due to degeneration of the vitreous body. The annual reported incidence of rhegmatogenous RD varied from 2.6 per 100,000 in France during the severe acute respiratory syndrome coronavirus-2 pandemic (COVID-19) [ 7 ], 9.5 to 12.1 per 100,000 in the United Kingdom [ 8 , 9 ], 13.7 per 100,000 in Denmark [ 10 ], 14.0 per 100,000 in Sweden [ 11 ] to 18.2 per 100,000 in the Netherlands [ 12 ]. Asians may have lower incidence of rhegmatogenous RD than Caucasians.…”

COVID‐19 reduced scleral buckling training in fellows and shifted young ophthalmologists' preference toward vitrectomy: An Asia‐Pacific survey

“…One possible explanation may be the fewer RRD patients presented during the pandemic due to all types of restrictions (e.g., lockdown). 15 Additionally, some trainees may have been redeployed for COVID-19-related work and thus were unable to maintain their fellowship training. 29 Another reason may be, as we have observed in the current study, that the ophthalmologists shifted their preferred surgical method from SB to PPV during the pandemic.…”

“…The geographical distribution of the fellowship programs is shown in Figure 1 and Table S2 (Supporting Information 1), and the fellowship experiences are also shown in Table 1. The median (IQR) duration of fellowship training was 15 months (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

“…12,13 Most existing studies regarding COVID-19 and RRD have focused on the case volume drop and patient characteristic changes (i.e., delayed presentations). [14][15][16][17][18] Few studies have discussed surgical decision changes. 16,19,20 Li et al 19 observed an increase in the proportion of PPV conducted in Beijing, China, and attributed it to the more complicated cases (e.g., RRD with choroidal detachment) presented.…”