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

Abstract

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.

The Impact of Covid-19 in the Follow-Up of Glaucoma Patients in a Tertiary Center: A Comparison Between Pre-Pandemic and Pandemic Periods

“… 32 Similar findings were reported for retinal surgery referrals, with reductions of 48.4%, 18.5% and 26.5% during the first, second and third waves, respectively, with an average decrease of 16.5% during the pandemic. 33 These findings are comparable with those reported herein: a 60% decrease in the number of filtering procedures, 93.65% in combined procedures and 87.44% in cyclodestructive procedures, with an overall decrease of 72.74% in glaucoma surgeries.…”

“…They also reported a decrease of 64.9% and 73.0% in the number of trabeculectomies, 40.5% and 58.9% in drainage implants, and 82.6% and 85.3% in cyclodestructive procedures when the 2-month lockdown period was compared to pre-lockdown months and corresponding 2 months of 2019, respectively. Furthermore, two reports from Poland investigating elective cataract surgeries 32 and rhegmatogenous retinal detachment 33 found a decrease in the number of referrals and procedures. Considering the mean number of elective cataract performed between 2016 and 2019 as baseline, the number of procedures decreased 77.5%, 51.5% and 29.7% during the first (March/2020-May/2020), second (October/2020-December/2020) and third (March/2020-April/2020) Covid-19 waves in the country, respectively, with an average decrease of 53.4% during the pandemic.…”

Impact of local COVID-19 alert levels on rhegmatogenous retinal detachment

“…Macular on/off status was evaluated by preoperative B scan of optical coherence tomography in all patients. As previously described, macula-off RRD was defined as detachment involving the fovea [ 17 ]. Recurrence of RD was defined as an additional surgical intervention for retinal re-detachment within 6 months postoperatively.…”

“…RRD patients had characteristics that indicated a longer RD duration in the early months of the pandemic including an increased ratio of macula-off RD and a prolonged duration of visual impairment [ 16 ]. It is also reported that local epidemic waves affected the delay in visits to the clinic [ 17 ]. However, reports focusing on the impact of local alert levels on RRD characteristics are scarce.…”

The Impact of the COVID-19 Pandemic on Ophthalmology Residents: A Narrative Review

“…Over the first few months of the pandemic outbreak, regarding ophthalmology societies, most ophthalmic departments suspended their elective clinical and surgical activities and restricted their practices to urgent cases only [ 3 , 4 , 5 ]. Moreover, the emergency situation in many places led to rotations of healthcare personnel, including trainees, who were redeployed to COVID-19 wards to fight the pandemic.…”