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Bovone C, De Rosa L, Pellegrini M, Ruzza A, Ferrari S, Camposampiero D, Ponzin D, Zauli G, Yu AC, Busin M. Deep Anterior Lamellar Keratoplasty Using Dehydrated versus Standard Organ Culture-Stored Donor Corneas: Prospective Randomized Trial. Ophthalmology 2024; 131:674-681. [PMID: 38160881 DOI: 10.1016/j.ophtha.2023.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE To compare the outcomes of deep anterior lamellar keratoplasty (DALK) using dehydrated versus standard organ culture-stored donor corneas for eyes with keratoconus. DESIGN Prospective, randomized, single-center trial conducted in Italy. PARTICIPANTS Adult patients (age ≥ 18 years) with keratoconus scheduled for elective DALK. METHODS Patients undergoing successful type 1 bubble pneumatic dissection using a standard DALK technique were randomized during surgery to receive either dehydrated (n = 30) or standard organ culture-stored (n = 30) donor corneas. MAIN OUTCOME MEASURES The primary study outcome was best spectacle-corrected visual acuity (BSCVA) 12 months after surgery. Secondary outcomes were refractive astigmatism (RA), endothelial cell density (ECD), and complication rates. RESULTS Postoperative BSCVA did not significantly differ between groups at both time points: mean difference at 6 months was 0.030 logarithm of the minimum angle of resolution (logMAR; 95% confidence interval [CI], -0.53 to 0.10 logMAR; P = 0.471) and at 12 months was -0.013 logMAR (95% CI, -0.10 to 0.08 logMAR; P = 0.764). No significant differences between groups were observed in terms of postoperative RA and ECD at all time points. In the first 3 days after DALK, an epithelial defect was present in 10 patients (33%) in the organ culture cornea group and in 29 patients (97%) in the dehydrated cornea group. Complete re-epithelialization was achieved by day 7 in all patients (100%) in both groups. CONCLUSIONS The study provides evidence that the use of dehydrated corneas is noninferior to the use of standard organ culture donor corneas for DALK. Corneal tissue dehydration represents a viable solution that can allow long-term cornea preservation and avoid wastage of unused corneas. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Cristina Bovone
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | - Luigi De Rosa
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | - Marco Pellegrini
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | | | | | | | - Diego Ponzin
- Fondazione Banca degli Occhi del Veneto, Venice, Italy
| | - Giorgio Zauli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Angeli Christy Yu
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | - Massimo Busin
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Ospedali Privati Forlì"Villa Igea," Forlì, Italy; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy.
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Salvetat ML, Musa M, Pellegrini F, Salati C, Spadea L, Zeppieri M. Considerations of COVID-19 in Ophthalmology. Microorganisms 2023; 11:2220. [PMID: 37764064 PMCID: PMC10538084 DOI: 10.3390/microorganisms11092220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
Since its emergence in early 2020, the SARS-CoV-2 infection has had a significant impact on the entire eye care system. Ophthalmologists have been categorized as a high-risk group for contracting the virus due to the belief that the eye may be a site of inoculation and transmission of the SARS-CoV-2 infection. As a result, clinical ophthalmologists, optometrists, and eyecare professionals have had to familiarize themselves with the ocular manifestations of COVID-19, as well as its treatments and vaccines. The implementation of measures to prevent the transmission of the virus, such as restrictions, lockdowns, telemedicine, and artificial intelligence (AI), have led to substantial and potentially irreversible changes in routine clinical practice, education, and research. This has resulted in the emergence of a new mode of managing patients in a routine clinical setting. This brief review aims to provide an overview of various aspects of COVID-19 in ophthalmology, including the ocular manifestations related to the disease, the modes of transmission of SARS-CoV-2 infection, precautions taken in ophthalmic practice to prevent the spread of the virus, drugs, and vaccines used in the treatment of COVID-19, the impact of the pandemic on patients, clinicians, and the eye care system as a whole, and the future of ophthalmology conditioned by this global pandemic experience.
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Affiliation(s)
- Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy
| | - Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Edo State, Nigeria
| | - Francesco Pellegrini
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, 00142 Rome, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Zein M, Wylegala A, Sripawadkul W, Al Bayyat G, Alvarez OP, Gutierrez AJ, Guerrero MA, Galor A, Karp CL. Corneal topography and tomography readings with mask wear during the COVID-19 pandemic. J Cataract Refract Surg 2023; 49:285-291. [PMID: 36399667 PMCID: PMC10043756 DOI: 10.1097/j.jcrs.0000000000001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To assess the effect of mask wear on corneal topography and tomography readings. SETTING Tertiary ophthalmic center. DESIGN Prospective, observational, comparative study. METHODS Subjects underwent imaging with the Tomey TMS-4a topographer and the Oculus Pentacam HR tomographer. Imaging was performed without a mask, and then testing was repeated while wearing 3 different masks: Halyard Level 2, Halyard Level 3, and KN95. Measurements during mask wear were compared with measurements without a mask. The Kruskal-Wallis analysis of variance grouped test was used to compare mean differences without vs with mask wear on measurements. The Chi-square test was used to compare frequency of differences between different masks and against-the-rule vs with-the-rule astigmatism. The frequencies of clinically significant changes in axis of astigmatism, magnitude of astigmatism, and mean keratometry (K) values were calculated. RESULTS 52 eyes were included in the study with a mean age of 34.71. Mask wear did not show statistically significant differences in mean topography and tomography measurements compared with without mask wear for all parameters. However, the majority, 53% (83/156) had a >10 degrees and 41% (64/156) had >15 degrees change in axis of astigmatism on topography when wearing a mask compared with no mask wear. CONCLUSIONS Mask wear did not result in statistically significant mean changes in K readings on topography and tomography. However, the axis of astigmatism varied >10 degrees in most of the patients. Axis determination should be interpreted with caution regarding refractive surgery and/or toric intraocular lens planning in individuals whose measurements were obtained while wearing a mask.
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Affiliation(s)
- Mike Zein
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida (Zein, Wylegala, Sripawadkul, Al Bayyat, Alvarez, Gutierrez, Guerrero, Galor, Karp); Department of Ophthalmology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand (Sripawadkul); Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, Florida (Galor)
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Lee SC, Alber S, Lieng MK, Emami-Naeini P, Yiu G. Teleophthalmology Using Remote Retinal Imaging During the COVID-19 Pandemic. Telemed J E Health 2023; 29:81-86. [PMID: 35612464 PMCID: PMC9918349 DOI: 10.1089/tmj.2022.0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/09/2022] [Accepted: 04/15/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction: Lower insurance reimbursements have limited the financial sustainability of remote eye screening programs. Greater utilization and insurance coverage for teleophthalmology screening during the coronavirus disease 2019 (COVID-19) pandemic in 2020 may enhance awareness and expand remote retinal imaging services. This retrospective cross-sectional study evaluates utilization and insurance coverage for remote retinal imaging in the United States in 2020. Methods: We analyzed teleretinal imaging utilization and insurance payments from January 1 to December 31, 2020, using the Optum Labs Data Warehouse, a comprehensive national database of deidentified administrative claims for commercial and Medicare Advantage enrollees in the United States. We evaluated frequency of claims and insurance payment for services using the Current Procedural Terminology codes 92227 and 92228 for remote eye imaging by any provider, and 92250 for fundus photography by non-eye care providers. Results: The use of remote retinal imaging in the United States declined rapidly during the initial COVID-19 lockdown from 3,627 claims in February 2020 to 1,414 claims in April 2020, but returned to 3,133 claims by December 2020, similar to mean prepandemic levels in 2019 (2,841 ± 174.8 claims). The proportion of insurance payments for remote imaging increased temporarily from 47.4% in February to 56.7% in April, and then returned to 45.9% in December of 2020. Discussion: Utilization of remote retinal imaging declined steeply, while the insurance coverage increased during the initial COVID-19 lockdown in 2020, but returned to prepandemic levels by end of the year. Changes in utilization and relaxed restrictions on insurance reimbursements for teleophthalmology during the COVID-19 pandemic were not sustained.
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Affiliation(s)
- Sophie C. Lee
- Department of Ophthalmology & Vision Science, University of California, Davis Eye Center, Sacramento, California, USA
| | - Susan Alber
- Division of Biostatistics, Department of Public Health Sciences, Clinical and Translational Science Center, University of California, Davis, Sacramento, California, USA
| | - Monica K. Lieng
- Department of Ophthalmology & Vision Science, University of California, Davis Eye Center, Sacramento, California, USA
- School of Medicine, University of California, Davis, Sacramento, California, USA
| | - Parisa Emami-Naeini
- Department of Ophthalmology & Vision Science, University of California, Davis Eye Center, Sacramento, California, USA
| | - Glenn Yiu
- Department of Ophthalmology & Vision Science, University of California, Davis Eye Center, Sacramento, California, USA
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Bruzard H, Soler P, Varenne F, Sentis V, Fournié P, Soler V. [Influence of the COVID-19 pandemia on the ophthalmologic emergency department in the Toulouse University Hospital during the first lockdown from March the 17th to May the 10th of 2020]. J Fr Ophtalmol 2023; 46:2-10. [PMID: 36503813 PMCID: PMC9701637 DOI: 10.1016/j.jfo.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION We conducted this study to assess the impact of the COVID-19 pandemic and the lockdown in France from March 17, 2020 to May 10, 2020, on the ophthalmic emergency department at Toulouse University Hospital, compared to the period from March 2 to March 16, 2020. MATERIALS AND METHODS This was a retrospective observational study, conducted in the ophthalmic emergency department of Toulouse University Hospital. We included the patients presenting to the emergency department from March 2 to May 10, 2020. We recorded age, sex, day of visit, time until care was received, past ocular history, outpatient or inpatient status, final diagnosis and its severity, outpatient or inpatient disposition, and medical or surgical treatment after the emergency department visit. RESULTS We found a substantial decrease in the number of patients per day, mostly during the first month of the lockdown: 44 patients per day before the lockdown compared to 23 patients per day during the first month, followed by 38 patients per day for the second month of lockdown; more patients visiting promptly; and elderly patients represented a higher proportion of patients. CONCLUSION The first lockdown in France due to the COVID-19 pandemic had an impact on the Toulouse ophthalmic emergency department, especially concerning the number of patients per day; this study helps to assess individual behavior in this context of a public health crisis.
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Affiliation(s)
- H. Bruzard
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France,Auteur correspondant. 5, rue Jacob-Insel, Résidence Emeraude, Bâtiment D, Appartement 139, 31200 Toulouse, France
| | - P. Soler
- EFS Occitanie centre de soins, 1, avenue Irène-Joliot-Curie, Toulouse, France
| | - F. Varenne
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - V. Sentis
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - P. Fournié
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France,Université Toulouse III, 31000 Toulouse, France
| | - V. Soler
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France,Université Toulouse III, 31000 Toulouse, France,SV3 team, CERCO, UMR5549, Toulouse, France
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Zhu R, Yu ZY, Han L. Insights on the possibility of SARS-CoV-2 transmission through the eyes. Int J Ophthalmol 2022; 15:1857-1863. [PMID: 36404966 PMCID: PMC9631193 DOI: 10.18240/ijo.2022.11.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/26/2022] [Indexed: 12/12/2022] Open
Abstract
A novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCOV), causing coronavirus disease 2019 (COVID-19), has rapidly spread to most countries and regions worldwide since it broke out at the end of 2019. Epidemic of the virus produces a tremendous pressure on the global health systems. With progressive insight into SARS-CoV-2, the role of eye tissue has attracted wide attention in the spread of COVID-19. Whether SARS-CoV-2 can enter the human body through eyes and cause infection? The fact that unprotected exposure of the eyes to 2019-nCoV might have allowed the virus to infect the body implies that 2019-nCOV can invade eye tissue and set foot in organism. Facing the severe challenge of preventing spread of the COVID-19, combined with the high-risk environment of ophthalmology, it is crucial to investigate ocular tropism of coronavirus. This paper explores the possibility of coronavirus transmission through the eye from aspects of probable mechanisms, clinical cases, detection of coronavirus; and puts forward precautions for ophthalmologists and nurses. Consequently, this review reveals our understanding of ocular tropism of coronavirus and contributes to determining risk of ocular transmission, raising awareness of necessary eye protection among medical workers and reducing further prevalence of SARS-CoV-2.
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Affiliation(s)
- Rui Zhu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China,Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China,Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China,China Medical University, Shenyang 110122, Liaoning Province, China
| | - Zi-Yan Yu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China,Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China,Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China
| | - Lin Han
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China,Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China,Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China
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Kaushik J, Riyaz E, Chaitanya YVK, Nair R, Kumar A, Singh A, Parihar JKS, Srikant S, Shetty R. An insight into the altered ophthalmic dynamics during the COVID-19 pandemic. Indian J Ophthalmol 2022; 70:3643-3648. [PMID: 36190064 PMCID: PMC9789823 DOI: 10.4103/ijo.ijo_254_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose The objective of this survey-based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology. Methods The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question. Results A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic-appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor. Conclusion The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department-based and surgical procedures in ophthalmology.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India,Correspondence to: Dr. Jaya Kaushik, Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra - 411 040, India. E-mail:
| | - Eram Riyaz
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - YVK Chaitanya
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Renu Nair
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ashok Kumar
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ankita Singh
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - JKS Parihar
- Department of Ophthalmology and Post Graduate Training and Education, Centre for Sight, New Delhi, India
| | - S Srikant
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rakesh Shetty
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
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Tsironi S, Kavvadas D, Delis G, Bekiaridou A, Kapourani V, Loizou F, Apostolidou PS, Misiou K, Theofrastou E, Panakleridou T, Psimenidou E, Sarafi A, Fadel E, Karachrysafi S. Cataract Surgery during the COVID-19 Pandemic: Insights from a Greek Tertiary Hospital. Geriatrics (Basel) 2022; 7:geriatrics7040077. [PMID: 35893324 PMCID: PMC9394252 DOI: 10.3390/geriatrics7040077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/12/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background: COVID-19 has affected everyday clinical practice, having an impact on the quality of healthcare provided, even in eye clinic departments. The aim of this study is to evaluate the consequences of this worldwide pandemic on cataract surgery in a Greek tertiary university hospital. Methods: A total of 805 patients were included in this study. The number of cataract surgeries (CS), the type, the unilateral or bilateral appearance as well as the stage of cataract were recorded for the months between January and June 2019 (pre-COVID period) and compared with the same period in 2021 (during the pandemic outbreak) in the Department of Ophthalmology of Thessaloniki General Hospital G. Papanikolaou. Results: A significant reduction in the number of CS as well as a significant increase in advanced and/or bilateral cataracts in 2021 compared to the pre-COVID period were observed. Conclusions: The COVID-19 pandemic has affected equally the value of ophthalmic interventions as well as the patients’ quality of life, being a powerful reminder of the significant physical and psychological benefits of CS, especially for older adults and patients with comorbidities.
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Affiliation(s)
- Sevasti Tsironi
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Dimitrios Kavvadas
- Laboratory of Histology-Embryology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Correspondence: (D.K.); (S.K.)
| | - Georgios Delis
- Laboratory of Pharmacology, Faculty of Health Sciences, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Alexandra Bekiaridou
- Laboratory of Histology-Embryology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Viktoria Kapourani
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Fragkeskos Loizou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Panagiota-Sofia Apostolidou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Konstantina Misiou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Efstratios Theofrastou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Thaleia Panakleridou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Eleni Psimenidou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Anastasia Sarafi
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Elie Fadel
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Sofia Karachrysafi
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
- Laboratory of Histology-Embryology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Correspondence: (D.K.); (S.K.)
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Pellegrini M, Ferrucci E, Guaraldi F, Bernabei F, Scorcia V, Giannaccare G. Emerging application of Google Trends searches on "conjunctivitis" for tracing the course of COVID-19 pandemic. Eur J Ophthalmol 2022; 32:1947-1952. [PMID: 34431411 PMCID: PMC9294616 DOI: 10.1177/11206721211042551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/07/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE The aim of the present study was to use Google Trends for evaluating the association between the internet searches of the term "conjunctivitis" and the daily new cases of COVID-19. METHODS The relative search volume (RSV) of conjunctivitis from January 1 to April 16, 2019 (control group), January 1 to April 16, 2020 (first wave), and October 1 to December 31, 2020 (second wave) was obtained using Google Trends in Italy, France, United Kingdom, and United States. The number of COVID-19 daily new cases in the same countries were retrieved from Worldometer. Lag time correlation analyses were performed to evaluate the relationship between RSV and daily new cases (Pearson's correlation coefficient). RESULTS During the first wave, the lagged RSV of conjunctivitis was significantly correlated with the number of COVID-19 daily new cases in all investigated countries. The highest correlation coefficients were obtained with a lag of 16 days in Italy (R = 0.868), 18 days in France (R = 0.491), 15 days in United Kingdom (R = 0.883), and 14 days in United States (R = 0.484) (all p < 0.001). Conversely, no significant correlations were found in the second wave and in the control group. CONCLUSION Google Trends searches on conjunctivitis were significantly correlated with COVID-19 daily new cases during the first wave in Italy, France, United Kingdom, and United States, with a lag of 14-18 days. Repeating the analysis for the second wave, however, no significant correlations were found in any of the investigated countries.
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Affiliation(s)
- Marco Pellegrini
- Ophthalmology Unit, S. Orsola-Malpighi
University Hospital, University of Bologna, Bologna, Italy
| | - Edoardo Ferrucci
- Department of Business and Management,
LUISS Guido Carli, Rome, Italy
- GREThA UMR CNRS 5113 – Université de
Bordeaux, Bordeaux, France
| | - Fabio Guaraldi
- Ophthalmology Unit, S. Orsola-Malpighi
University Hospital, University of Bologna, Bologna, Italy
| | - Federico Bernabei
- Ophthalmology Unit, S. Orsola-Malpighi
University Hospital, University of Bologna, Bologna, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University
of “Magna Græcia,” Catanzaro, Italy
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10
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A Systematic Literature Review and Bibliometric Analysis of Ophthalmology and COVID-19 Research. J Ophthalmol 2022; 2022:8195228. [PMID: 35646394 PMCID: PMC9133895 DOI: 10.1155/2022/8195228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/05/2022] [Indexed: 12/12/2022] Open
Abstract
This review is proposed to summarize the updates on COVID-19 and ophthalmology along with the bibliometric features of articles that have been published since the beginning of the COVID-19 outbreak. The databases, including PubMed, Scopus, and Web of Science, were searched using "Coronavirus," "COVID-19," "SARS-CoV-2," "pandemic," "ophthalmology," "ophthalmic," and "eye" keywords. All published articles except commentaries, errata, and corrigenda up to April 2021 were included. Titles and abstracts were screened, and ophthalmology-focused articles were collected. The bibliographic information of the articles, such as the name and country of the first author, type of study, date of publication, language, and journal name, were extracted. Included studies were assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. After systematic searching, 2,669 distinct articles were screened by title/abstract, and 1,174 ophthalmology-focused articles were selected to be reviewed. Ophthalmology-focused publications accounted for less than 0.5 percent of the total COVID-19-related articles. Most of the articles were published in the Indian Journal of Ophthalmology, and the main publication type was "original article." Almost 88% of the publications were in English. There was a decline in the publication rate during the initial months of 2021 compared with the middle and last months of 2020. Most of the publications were affiliated with the United States of America. However, Singapore and the United Kingdom were the countries with the highest number of publications after population adjustment. Furthermore, a comprehensive review on major topics including SARS-CoV-2 ocular tropism, ophthalmic manifestations, ocular complications due to COVID-19 treatment strategies, the pandemic effect on ophthalmology care and operations, myopia progression during the pandemic, and telemedicine was conducted.
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11
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Liu J, Ma J, Ahmed IIK, Varma DK. Effectiveness of a 3D-printed mask fitter in an Ophthalmology setting during COVID-19. CANADIAN JOURNAL OF OPHTHALMOLOGY 2022; 57:161-166. [PMID: 33838139 PMCID: PMC7972674 DOI: 10.1016/j.jcjo.2021.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/19/2021] [Accepted: 03/10/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess the effectiveness of a 3D-printed custom mask fitter in lieu of N95 respirators among ophthalmologists and other eye care professionals who may not be prioritized to receive N95 respirators amidst the coronavirus disease 2019 pandemic. METHODS This was a proof-of-concept study from a tertiary eye care center in Oakville, Canada. All participants underwent the N95 Qualitative Fit Test with a custom mask fitter secured over an American Society for Testing and Materials Level 3 face mask. Participants answered a 10-point Likert scale questionnaire on comfort, ease of use, and feasibility of the custom mask fitter, as well as comfort of a regular face mask. RESULTS Twenty participants were recruited. Of the 20 recruited, 18 (90%) successfully passed the fit test. The median scores for comfort, ease of use, and everyday feasibility for the custom mask fitter were 3.5, 4.5, and 3, respectively, whereas the median score for comfort of a regular face mask was 8.5. CONCLUSION A reusable, low-cost, 3D-printed custom mask fitter is a potential effective alternative to an N95 respirator among eye care professionals but may require improvement in its design and comfort. This is especially relevant in the context of a limited supply of N95 respirators amidst a global pandemic.
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Affiliation(s)
| | | | | | - Devesh K. Varma
- Correspondence to Devesh Varma, 2201 Bristol Circle, Suite 100, Oakville, ON, L6H 0J8, Canada
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12
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ÇELİK DÜLGER S, ÇITIRIK M, BAHADİR CAMGOZ E, TEKE MY. Comparison of ocular emergencies in the COVID-19 pandemic and pre-pandemic period in the tertiary hospital of Turkey. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1099202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: To evaluate clinical characteristics and alterations in the of patients admitted to the ocular emergency department (ED) of a tertiary hospital during coronavirus disease period in 2019 (COVID-19) and pre-pandemic period. Also, we intended to share our strategy and experience to prevent disease transmission to health-care staff during patient submission.
Material and Method: In this study, 45901 patients who applied to ED between January and May in 2020 were reviewed retrospectively for ocular manifestations. The five months divided into two groups as the pre-pandemic period and the pandemic period. Clinical and demographic data were collected. The proportion of urgent and non-urgent cases in the pre-pandemic and pandemic period was compared.
Results: A total of 30,576 patients (66.6%) admitted to ED before COVID-19 and 15,325 patients admitted (33.4%) during COVID-19 era. Five hundred thirty-eight (1.8%) of cases admitted in the pre-pandemic period, and 395 (2.6%) of the cases admitted in the pandemic period were in the real urgent category. Conjunctivitis, blepharitis and hordeolum, dry eye diseases, corneal diseases were the most common conditions in both pre-pandemic and pandemic periods.
Conclusion: This study showed that admissions to ED for ocular conditions during the pandemic period decreased significantly, and the rate of real urgent cases increased. Yet even during the pandemic period, non-urgent patients continue to come to the ED.
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Affiliation(s)
| | - Mehmet ÇITIRIK
- UNIVERSITY OF HEALTH SCIENCES, ANKARA ULUCANLAR HEALTH RESEARCH CENTER
| | | | - Mehmet Yasin TEKE
- UNIVERSITY OF HEALTH SCIENCES, ANKARA ULUCANLAR HEALTH RESEARCH CENTER
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13
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Bello NR, Nelson LB, Gunton KB. Practice Patterns of Pediatric Ophthalmologists During the COVID-19 Pandemic. J Pediatr Ophthalmol Strabismus 2022; 59:145-150. [PMID: 34928762 DOI: 10.3928/01913913-20210921-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To report the use of protective personal equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic. METHODS A 12-question multiple-choice survey was posted on a discussion board used by members of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Respondents provided information about their experience, PPE use, office equipment, and approach to care during the COVID-19 pandemic. RESULTS One hundred twenty-eight pediatric ophthalmologists completed the survey. Eighty-seven (68.0%) identified as in private practice, whereas 41 (32.0%) identified as in an academic setting. Sixty-nine pediatric ophthalmologists (53.9%) reported routinely using N95 respirators, 72 (56.3%) reported wearing medical scrubs, 41 (32.0%) reported using disposable gloves, 33 (25.7%) reported wearing goggles, and 12 (9.4%) reported using face shields during office examinations. One hundred twenty-one pediatric ophthalmologists (94.5%) reported having slit lamps with plastic shields and 52 (40.6%) reported having phoropters with plastic shields. Ninety-nine (77.3%) responded that they would see a patient older than 2 years who refused to wear a mask for a nonemergency visit. CONCLUSIONS Practice patterns of pediatric ophthalmologists have varied during the COVID-19 pandemic. [J Pediatr Ophthalmol Strabismus. 2022;59(3):145-150.].
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14
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Tan TF, Li Y, Lim JS, Gunasekeran DV, Teo ZL, Ng WY, Ting DS. Metaverse and Virtual Health Care in Ophthalmology: Opportunities and Challenges. Asia Pac J Ophthalmol (Phila) 2022; 11:237-246. [PMID: 35772084 DOI: 10.1097/apo.0000000000000537] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The outbreak of the coronavirus disease 2019 has further increased the urgent need for digital transformation within the health care settings, with the use of artificial intelligence/deep learning, internet of things, telecommunication network/virtual platform, and blockchain. The recent advent of metaverse, an interconnected online universe, with the synergistic combination of augmented, virtual, and mixed reality described several years ago, presents a new era of immersive and real-time experiences to enhance human-to-human social interaction and connection. In health care and ophthalmology, the creation of virtual environment with three-dimensional (3D) space and avatar, could be particularly useful in patient-fronting platforms (eg, telemedicine platforms), operational uses (eg, meeting organization), digital education (eg, simulated medical and surgical education), diagnostics, and therapeutics. On the other hand, the implementation and adoption of these emerging virtual health care technologies will require multipronged approaches to ensure interoperability with real-world virtual clinical settings, user-friendliness of the technologies and clinical efficiencies while complying to the clinical, health economics, regulatory, and cybersecurity standards. To serve the urgent need, it is important for the eye community to continue to innovate, invent, adapt, and harness the unique abilities of virtual health care technology to provide better eye care worldwide.
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Affiliation(s)
- Ting Fang Tan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Yong Li
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Jane Sujuan Lim
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | | | - Zhen Ling Teo
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Wei Yan Ng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
| | - Daniel Sw Ting
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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15
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Ashour DM, Elkitkat RS, Gabr H, Yosef M, Singh Grewal D, Saleh MI. Challenges of personal protective equipment use among ophthalmologists during the COVID-19 pandemic: A multicenter international study. Eur J Ophthalmol 2022; 32:1398-1405. [PMID: 34180262 PMCID: PMC9111902 DOI: 10.1177/11206721211028037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/05/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To explore the possible challenges and difficulties of using Personal Protective Equipment (PPE) in ophthalmic practice during the Coronavirus disease 2019 (COVID-19) pandemic. METHODS This is a multicenter, international survey among practicing ophthalmologists across different countries. The survey was conducted from September 9th to October 24th, 2020. It included a total of 23 questions that navigated through the currently adopted recommendations in different clinical situations. The survey also assessed the convenience of using various PPE in ophthalmic practice and addressed the clarity of the examination field while using various PPE during clinical or surgical procedures. RESULTS One hundred and seventy-two ophthalmologists completed the survey (101 from Egypt, 50 from the USA, and 21 from four other countries). The analysis of the responses showed that most ophthalmologists use face masks without significant problems during their examinations, while face shields followed by protective goggles were the most inconvenient PPE in the current ophthalmic practice. Moreover, most of the participants (133, 77.3%) noticed an increase in their examination time when using PPE. Furthermore, a considerable percentage of the respondents (70, 40.7%) stopped using one or more of the PPE due to inconvenience or discomfort. CONCLUSIONS Due to the unique nature of the ophthalmic examination, certain PPE are not ophthalmologist-friendly. Innovative PPE should be tailored for prompt, more convenient, and clearer ophthalmological practice.
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Affiliation(s)
- Doaa Maamoun Ashour
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
| | - Rania Serag Elkitkat
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
- Watany Eye Hospital, Cairo, Egypt
- Watany Research and Development Center,
Cairo, Egypt
| | - Hesham Gabr
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
- Department of Ophthalmology, Duke
University, Durham, NC, USA
| | - Mostafa Yosef
- Department of Community, Environmental
and Occupational Medicine, Ain Shams University, Cairo, Egypt
| | | | - Mohamed Ibrahim Saleh
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
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16
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Eppenberger LS, Golla K, Schmid MK. Emergency Vitrectomies for Retinal Detachment Before and During the Coronavirus Pandemic - A Retrospective Single Centre Analysis. Klin Monbl Augenheilkd 2022; 239:476-483. [PMID: 35472790 PMCID: PMC9042420 DOI: 10.1055/a-1808-6258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background
While the corona pandemic and the resulting containment measures affect the number of elective surgical procedures, the impact on emergency surgical interventions is less
tangible. This analysis quantifies the frequency of emergency vitrectomies for retinal detachment and investigates underlying factors.
Methods
Retrospective identification of patients who underwent primary emergency vitrectomies for retinal detachment at the Cantonal Hospital of Lucerne between
01.01.2018 – 31.12.2020. Parameters were collected, including demographics, date of hospitalisation, reported onset of symptoms, pre-operative best corrected visual acuity (BCVA),
involvement of the macula, and canton of residence.
Results
Overall, a total of 665 patients with 683 eyes underwent emergency surgery for primary retinal detachment in the time span of 01.01.2018 – 31.12.2020. Median monthly number
of surgeries was 20. During the first Swiss national lockdown (16.03.2020 – 19.04.2020), a minimum of 9 vitrectomies was recorded in March 2020. A maximum of 36 vitrectomies was conducted in
August 2020. The mean age of patients was 61.5 years. Of the 665 patients, 133 (20.0%) were residents of the canton of Ticino. Median pre-operative BCVA was 0.25 over all three years, and no
significant reduction in pre-operative BCVA was observed during or after the lockdown. The proportion of eyes with involvement of the macula was 52.2%. In 2018, this proportion (47.6%) was
significantly lower than in 2019 and 2020 (Chi
2
test, p < 0.001). However, cases with macular involvement in post lockdown months were not more frequent. Median time in days
from reported symptom onset to hospitalisation was 5 days. In April 2020, the proportion of patients with > 14 days symptom duration was significantly higher (Chi
2
test,
p < 0.001). During the lockdown, there was a significant reduction in cases from Ticino. Also, patients from Ticino showed proportionally longer symptom duration after the lockdown.
Conclusion
A significant reduction in the number of emergency vitrectomies was observed for the initial period of the coronavirus pandemic. Delayed emergency presentation is not
assumed, since there was no increase in severity (i.e. macular involvement) or prolonged symptoms in the months following the lockdown. More protracted symptoms were only observed in
patients from Ticino. The initial low numbers were generally made good later in the year.
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Affiliation(s)
- Leila Sara Eppenberger
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Kathrin Golla
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
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17
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Sanak F, Faes L, Eppenberger L, Baenninger P, Kaufmann C, Golla K, Bachmann L, Buhl D, Schmid MK, Thiel M. Effect of Protective Measures on the Risk of SARS-CoV-2 Infection among Eye Clinic Staff Members. Klin Monbl Augenheilkd 2022; 239:605-609. [PMID: 35472816 DOI: 10.1055/a-1785-5226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Switzerland was strongly affected by the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that resulted in a nationwide lockdown in March 2020. Ophthalmologists were at most risk of contracting a SARS-CoV-2 infection due to their close working distance from patients. The aim of the study is to evaluate the overall effectiveness of protective measures on the risk of SARS-CoV-2 infection among employees in a large public eye hospital. MATERIAL AND METHODS After lifting the lockdown in April 2020, standard precaution measures were taken, such as no handshaking and the use of operating face masks and a protective plastic shield on slit lamps and diagnostic devices. Only patients with no signs of SARS-CoV-2 disease were seen during the study period. Specific anti-SARS-CoV-2 IgG antibody titers were measured in eye clinic employees at the end of April 2020 (1st test phase) and in January 2021 (2nd test phase). The prevalence of SARS-CoV-2 IgG antibody titers among employees with daily patient contact was compared to staff members with no patient contact. RESULTS The SARS-CoV-2 prevalence in employees with daily patient contact, with 0% in the 1st phase and 7.4% in the 2nd phase, was not significantly higher than the prevalence in the control group with no patient contact (0.9% in the 1st phase, p = 0.4; and 8.6% in the 2nd phase, p = 0.8). Furthermore, physicians were not at a significantly higher risk of SARS-CoV-2 infection compared to technicians, nurses, or office staff. CONCLUSIONS This study shows that the abovementioned precaution measurements are effective in preventing transmission of SARS-CoV-2 infection in eye hospitals and enable us to resume practicing ophthalmology in a safe manner.
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Affiliation(s)
- Frantisek Sanak
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Medical Faculty, University of Zürich, Zürich, Switzerland
| | - Livia Faes
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Medical Retina and Uveitis, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | | | | | - Claude Kaufmann
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Medical Faculty, University of Zürich, Zürich, Switzerland
| | - Kathrin Golla
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Lucas Bachmann
- Medical Faculty, University of Zürich, Zürich, Switzerland.,Research Consultancy, Medignition INC, Zürich, Switzerland
| | - Daniela Buhl
- Laboratory Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Martin K Schmid
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Michael Thiel
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Medical Faculty, University of Zürich, Zürich, Switzerland
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18
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Zarranz-Ventura J, Nguyen V, Creuzot-Garcher C, Verbraak F, O Toole L, Invernizzi A, Viola F, Squirrel D, Barthelmes D, Gillies MC. INTERNATIONAL IMPACT OF THE COVID-19 PANDEMIC LOCKDOWN ON INTRAVITREAL THERAPY OUTCOMES: Fight Retinal Blindness Registry. Retina 2022; 42:616-627. [PMID: 34907129 DOI: 10.1097/iae.0000000000003368] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the impact of the COVID-19 pandemic lockdowns on the outcomes of eyes treated for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion in eight countries. METHODS A multicenter international database study of 5,782 eyes (4,708 patients) receiving intravitreal antivascular endothelial growth factor injections before, during, and after national lockdowns. The baseline visit was defined as the last visit within 3 months before lockdown, and prelockdown and postlockdown periods were defined as 6 months before and after the lockdown date. RESULTS Eyes with neovascular age-related macular degeneration (n = 4,649) lost vision in all countries in proportion to the reduced number of injections. The mean visual acuity change postlockdown ranged from -0.4 to -3.8 logarithm of the minimum angle of resolution letters, and the median number of injections/visits decreased from 4-5/4-7 to 2-4/2-4 postlockdown. The diabetic macular edema (n = 654) and retinal vein occlusion (n = 479) eyes' mean visual acuity change ranged from -2.8 to +1.7 letters and -1.6 to +0.1 letters, and the median number of injections/visits decreased from 2.5-5/4-6 to 1-3/2-4 and from 3-5.5/4-5 to 1-3.5/2-3.5, respectively. The 6-month dropout rates postlockdown were 20% for neovascular age-related macular degeneration, 27% for diabetic macular edema, and 28% for retinal vein occlusion. CONCLUSION This international study provides estimates of the impact of COVID-19 pandemic lockdown on intravitreal therapy and suggests that prioritizing neovascular age-related macular degeneration eyes seems appropriate.
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Affiliation(s)
- Javier Zarranz-Ventura
- Institut Clínic of Ophthalmology (ICOF), Hospital Clínic, Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Vuong Nguyen
- Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, Australia
| | | | - Frank Verbraak
- Amsterdam University Medical Center (UMC), Amsterdam, The Netherlands
| | | | - Alessandro Invernizzi
- Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, Australia
- Eye Clínic, Department of Biomedical and Clinical Science "L. Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Francesco Viola
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - David Squirrel
- Department of Ophthalmology, Greenlane Clinical Centre and District Health Board, Auckland, New Zealand; and
| | - Daniel Barthelmes
- Department of Ophthalmology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Mark C Gillies
- Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, Australia
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19
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Mahjoub H, Zhang SX, Wang J, Memon W, Mostafa H, Breazzano MP. Characterizing the microbiota of instrumentation in ophthalmology clinics during and beyond the COVID-19 pandemic. Graefes Arch Clin Exp Ophthalmol 2022; 260:2585-2590. [PMID: 35355117 PMCID: PMC8967689 DOI: 10.1007/s00417-022-05639-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Increased ophthalmology-specific risk of novel coronavirus 2019 (SARS-CoV-2) transmission is well-established, increasing the fear of infection and causing associated decreased rates of procedures known to save vision. However, the potential transmission from exposure to clinic instrumentation is unknown, including which additional pathogens may be spreading in this context. This study seeks to fill this gap by characterizing the microbiota of instrumentation in ophthalmology clinics during the COVID-19 pandemic and identifying potential sources of pathogenic spread encountered by patients and healthcare workers. Methods Thirty-three samples were captured using standard cultures and media. Ten positive and negative controls were used to confirm proper technique. Descriptive statistics were calculated for all samples. Samples were collected from the retina (N = 17), glaucoma (N = 6), cornea (N = 6), and resident (N = 4) clinics with rigorous disinfection standards at a tertiary academic medical center. Standard media cultures and/or polymerase chain reaction (PCR) was performed for each sample. Results From 33 samples, more than half (17/33, 51.5%) yielded bacterial growth. Using two different molecular methods, three samples (3/33, 9%) tested positive for SARS-CoV-2 (cycle thresholds 36.48, 37.14, and 37.83). There was no significant difference in bacterial growth (95% confidence interval [95% CI]: − 0.644–0.358, p = 0.076) among different clinics (retina, glaucoma, cornea, resident). Staphylococcus (S.) epidermidis grew most frequently (12/35, 34%), followed by S. capitis (7/35, 20%), Micrococcus luteus (2/35, 5.7%), Corynebacterium tuberculostearicum (2/35, 5.7%), and Cutibacterium ([C.], Propionibacterium) acnes (2/35, 5.7%). C. acnes growth was more frequent with imaging device forehead rests (2/7, 28.6%) than other surfaces (0/26, 0%, 95% CI: 0.019–0.619, p = 0.040). No samples isolated fungus or adenovirus. Conclusions Most samples across subspecialty clinic instrumentation grew bacteria, and several tested positive for SARS-CoV-2. Many isolated pathogens have been implicated in causing infections such as endophthalmitis, conjunctivitis, uveitis, and keratitis. The clinical implications of the ophthalmology microbiome for transmitting nosocomial infections warrant optimization of disinfection practices, strategies for mitigating spread, and additional study beyond the pandemic. ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00417-022-05639-0.
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Affiliation(s)
- Heba Mahjoub
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD, 21287, USA
| | - Sean X Zhang
- Division of Medical Microbiology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
- Microbiology Laboratory, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Warda Memon
- Microbiology Laboratory, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Heba Mostafa
- Virology Laboratory, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Mark P Breazzano
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD, 21287, USA.
- Retina-Vitreous Surgeons of Central New York, Liverpool, NY, USA.
- Department of Ophthalmology & Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA.
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20
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Tingley J, Tauber J, Thuma T, Moon JY, Barmettler A. Impact of the COVID-19 Pandemic on Quantity and Characteristics of Ophthalmology Consults. Telemed J E Health 2022; 28:1547-1551. [PMID: 35244471 DOI: 10.1089/tmj.2021.0512] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To assess the COVID-19 exposure risk to consulting ophthalmologists and the pandemic effect on consultations at one of the most impacted hospital systems in New York. Methods: In a retrospective, cross-sectional study, ophthalmology consult notes and COVID-19 test results were collected from the electronic medical record from February to May in 2019 and 2020. Results: Of 2,215 total notes analyzed, consults decreased from 1,374 to 841 between years (p = 0.0002). In 2020, 22.5% of all consults were COVID tested and 2.4% were positive within 2 weeks of in-person evaluation. In 2020, 1.8% of consults were electronic. Ventilated patients increased between years (7.5% to 10.8%; p = 0.04). Conclusions: Although consultations decreased during the Spring 2020 peak, the majority (98.2%) remained as in-person evaluations. While few patients tested COVID positive, this likely reflects the limited availability of testing early in the pandemic. Consulting ophthalmologists remained at high risk of COVID-19 exposure during the pandemic peak.
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Affiliation(s)
- Jennifer Tingley
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York, USA
| | - Jenna Tauber
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York, USA
| | - Tobin Thuma
- Department of Pediatric Ophthalmology and Strabismus, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Jee-Young Moon
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Anne Barmettler
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York, USA
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21
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Abstract
PURPOSE OF REVIEW The current article reviews enhancements to the delivery of glaucoma care that developed in response to the coronavirus disease 19 (COVID-19) pandemic and are likely to persist beyond its resolution. RECENT FINDINGS Literature from the review period (2020-2021) includes reports highlighting contributions of the ophthalmology community to global health during the pandemic. Glaucoma practices worldwide have instituted more robust infection control measures to mitigate severe acute respiratory syndrome coronavirus 2 transmission in the outpatient setting, and many of these modifications will endure in the post-COVID era. Operational adjustments have led to the provision of more efficient glaucoma care. A hybrid care model involving technician-based diagnostic testing and subsequent virtual consultation with a glaucoma specialist has evolved as a useful adjunct to traditional face-to-face encounters with patients. SUMMARY Glaucoma specialists, patients, and staff have adapted to a 'new normal' of glaucoma care delivery during the COVID-19 pandemic. Although innovation has propelled several improvements to glaucoma care during this global health crisis, significant barriers to more widespread implementation of teleglaucoma still exist. Whether, and in what capacity, the pandemic has permanently altered glaucoma practice patterns remains to be seen.
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Affiliation(s)
- Kateki Vinod
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai and New York Eye and Ear Infirmary of Mount Sinai, New York, New York USA
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22
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Brant AR, Pershing S, Hess O, Rooney D, Goldberg J, Tabin G, Wang SY. The Impact of COVID-19 on Missed Ophthalmology Clinic Visits. Clin Ophthalmol 2021; 15:4645-4657. [PMID: 34916776 PMCID: PMC8667753 DOI: 10.2147/opth.s341739] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/25/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To measure the COVID-19 pandemic impact on missed ophthalmology clinic visits and the influence of patient and eye disease characteristics on likelihood of missing clinic visits before and during the pandemic. Patients and Methods A retrospective observational study analyzing eye clinic patients at a large tertiary care academic institution. We identified patients scheduled for eye care during pre-COVID-19 (January 1–February 29, 2020) and early COVID-19 (March 16–May 31, 2020) time periods. Missed appointment frequency and characteristics were evaluated during each time period. Multivariable logistic regression models were developed to examine adjusted odds of having at least one missed appointment during a given time period. Covariates included age, sex, race/ethnicity, marital status, preferred language (non-English vs English), insurance, distance from clinic, and diagnosis. Results Overall, 82.0% (n = 11,998) of pre-COVID-19 patients completed all scheduled visits, compared to only 59.3% (n = 9020) during COVID-19. Missed visits increased dramatically in late March 2020, then improved week by week through the end of May 2020. General ophthalmology/cataract and strabismus clinics had the highest rates of missed clinic visits during the COVID-19 period; neuro-ophthalmology, retina, cornea, oculoplastics and glaucoma had the lowest. Females, Blacks, Hispanics, Asians, ages 50+, and married patients had higher adjusted odds of missing clinic visits, both pre-COVID-19 and during COVID-19. Asian, elderly, and cataract patients had the highest adjusted odds of missing clinic visits during COVID-19 and had significant increases in odds compared to pre-COVID-19. Non-married, diabetic macular edema, and wet age-related macular degeneration patients had the lowest adjusted odds of missed visits during COVID-19. Conclusion Missed clinic visits increased dramatically during the COVID-19 pandemic, particularly among elderly and nonwhite patients. These findings reflect differences in eye care delivery during the pandemic, and they indicate opportunities to target barriers to care, even during non-pandemic eras.
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Affiliation(s)
- Arthur R Brant
- Byers Eye Institute, Stanford University, Stanford, CA, USA
| | - Suzann Pershing
- Byers Eye Institute, Stanford University, Stanford, CA, USA.,VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Olivia Hess
- Byers Eye Institute, Stanford University, Stanford, CA, USA
| | - David Rooney
- Byers Eye Institute, Stanford University, Stanford, CA, USA
| | | | - Geoffrey Tabin
- Byers Eye Institute, Stanford University, Stanford, CA, USA.,VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Sophia Y Wang
- Byers Eye Institute, Stanford University, Stanford, CA, USA
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23
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Eatz T, Al-Khersan H, Tanenbaum R, Sridhar J. Does social media have a place in ophthalmology practice? EXPERT REVIEW OF OPHTHALMOLOGY 2021; 16:329-331. [PMID: 34899961 DOI: 10.1080/17469899.2021.1941877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tiffany Eatz
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 7 Street Miami, FL 33136, United States of America
| | - Hasenin Al-Khersan
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 7 Street Miami, FL 33136, United States of America
| | - Rebecca Tanenbaum
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 7 Street Miami, FL 33136, United States of America
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 7 Street Miami, FL 33136, United States of America
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Davila-Siliezar P, Wer A, Barnoya J. SARS-CoV-2 seroprevalence in healthcare workers in a high-volume ophthalmology centre in Guatemala. Ann Med 2021; 53:1956-1959. [PMID: 34727801 PMCID: PMC8567863 DOI: 10.1080/07853890.2021.1993325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
PURPOSE To determine the seroprevalence of SARS-CoV-2 antibodies in eye healthcare workers (EHCW) in the largest ophthalmology centre in Guatemala and factors associated with antibody positivity. METHODS We conducted a cross sectional sero-survey in all the staff at the largest ophthalmology centre in Guatemala. Serum samples were collected and tested for total antibodies against SARS-CoV-2 employing Roche Elecsys Anti-SARS-CoV-2 Immunoassay. Results were reported as reactive or non-reactive. According to patient exposure the staff were divided into low risk (technicians, domestic and administrative staff) and high risk (nurses, ophthalmologists, anaesthesiologists, and optometrists). Among those with positive antibodies, they were given a survey that included demographic characteristics, COVID-19 exposure, and related symptomatology. Logistic regression was used to determine the factors associated with antibody positivity. RESULTS On November 25th a total of 94 healthcare workers were sero-surveyed, mean age was 34.15 years (±8.41), most (57.44%) were females. Seroprevalence was 18%, the majority (77%) were in the low-risk group; while 64% at high-risk, tested negative. Those at low exposure, were five times more likely to have antibodies than those at high exposure (OR:5.69; 95% CI 1.69-19.13). Age and gender were not associated to seropositivity. CONCLUSIONS We found a similar seroprevalence of SARS-CoV-2 antibodies in EHCW to what has been reported in other healthcare groups. Seropositivity was higher among HCW with fewer patient exposure, hence the probability of community transmission.Key messagesEven though eye healthcare workers are believed to be at higher risk of infection, the prevalence of antibodies against SARS-CoV-2 in this group is comparable to what has been reported previously in other healthcare groups.
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Affiliation(s)
| | - Alfonso Wer
- Department of Ophthalmology, Unidad Nacional de Oftalmología, Guatemala City, Guatemala
| | - Joaquin Barnoya
- Department of Ophthalmology, Unidad Nacional de Oftalmología, Guatemala City, Guatemala
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25
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Gammoh Y. Knowledge and Awareness of the Coronavirus Disease and Perceptions Towards Ophthalmic Practice Among Ophthalmologists. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
To investigate the level of awareness of ophthalmologists towards COVID-19 and their perceptions towards infection control in ophthalmic practice.
Methods:
A web-based survey was conducted using Google Forms during the month of December 2020. All ophthalmologists practicing in Sudan were invited to participate in the study. Participants who did not agree to the terms of the electronic consent form presented at the beginning of the questionnaire as well as those who did not complete the survey, were excluded from the analysis. Knowledge of causes, symptoms, and methods of transmission of COVID-19; ophthalmologists’ attitudes and perceptions towards COVID-19 and clinical practice, including contact lens practice, were assessed using a set of 26 multiple-choice close-ended questions.
Results:
Of the 307 participants, 77.4% were in the age range 30-40 years and 73% were contact lens practitioners. While 96.1% acknowledged the scientific name of COVID-19, 46.9% were aware of its cause. Ophthalmologists aged 40-50 years were more likely to agree that air-puffing tonometer risks infection spread (OR 1.62, 95% CI: 0.27-9.70, p<0.01). Ophthalmologists aged 30-40 years were more likely to agree that a slit lamp shield would reduce infection risk (OR 1.52, 95% CI: 0.33-6.96, p<0.01). Contact lens practitioners were more likely to perceive that frequent replacement contact lens use can increase the infection spread (OR 2.64, 95% CI: 1.17-5.94, p<0.01).
Conclusion:
Ophthalmologists in Sudan demonstrated a mixed level of knowledge of the causes, symptoms, and modes of transmission of COVID-19. While the majority were able to identify the protective measures generally required by medical practitioners and patients, there was a limited level of knowledge regarding protective measures specific to ophthalmic practices, especially when dealing with contact lenses. Official national guidelines about safe ophthalmic service provision during the COVID-19 pandemic are recommended.
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26
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The Impact of the COVID-19 Pandemic on Ophthalmology Residents: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111567. [PMID: 34770081 PMCID: PMC8583285 DOI: 10.3390/ijerph182111567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 12/31/2022]
Abstract
The ongoing outbreak of the coronavirus disease 2019 (COVID-19) pandemic has drastically affected medical societies. We aim to provide an overview and summarize the information published so far concerning the impact of the COVID-19 pandemic on ophthalmology residency programs and the mental wellbeing of trainees, and to establish factors to help maintain successful residency training to ensure high-quality, specialist ophthalmic training. A literature search was conducted in October 2021 of the PubMed database for articles assessing the impact of the COVID-19 pandemic on the mental health of ophthalmology trainees and on ophthalmology residency programs. Cross-sectional survey studies, editorials, articles in scientific journals, letters to editors, and commentaries were considered; finally, 19 studies were included after excluding abstract-only publications and conference posters. The studies’ demographic details, participant characteristics, interventions, outcomes, and limitations were extracted. Our summarized information showed the alarmingly significant impact of the COVID-19 pandemic on ophthalmology trainees’ mental health and the associated considerable changes in ophthalmic training programs. Thus, in future, virtual training and surgical simulators should be permanently introduced, in addition to traditional teaching, to complete successful ophthalmology residency programs. Additionally, we emphasize the need for a widely facilitated and encouraged access to psychological support programs for healthcare workers, including ophthalmologists.
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27
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Naguib MM, Ghauri S, Mukhopadhyay A, Schefler AC. ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTIONS DURING THE COVID-19 PANDEMIC WITH IMPLEMENTATION OF UNIVERSAL MASKING. Retina 2021; 41:2208-2214. [PMID: 33958531 DOI: 10.1097/iae.0000000000003193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the rates of postintravitreal injection-related endophthalmitis during the COVID-19 pandemic with institution of both physician and patient face masking. METHODS All eyes receiving intravitreal injections of any kind from a single large tertiary retina practice in Houston, TX before (August 2017-March 22, 2020) and after (March 23, 2020-September 2020) COVID-19 pandemic universal masking protocols. The total number of injections and cases of acute injection-related endophthalmitis were determined from billing records and subsequent retrospective chart review. The primary outcome was the rate of endophthalmitis after intravitreal injection. Secondary outcomes included visual acuity, time until initial presentation, patient age, and differences in the overall number of injections performed monthly pre-COVID-19 and post-COVID-19. RESULTS A total of 134, 097 intravitreal injections were performed during the study period (111,679 pre-COVID-19 and 22,418 post-COVID-19 masking protocols). A total of 41 cases of acute endophthalmitis occurred in the pre-COVID group (0.04%, one in 2,500) and 7 cases in the post-COVID group (0.03%, one in 3,333) P = 0.85. CONCLUSION In this single center, retrospective study, the implementation of universal patient and physician masking as practiced during the COVID-19 pandemic did not significantly affect the rate of postintravitreal injection endophthalmitis.
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Affiliation(s)
- Mina M Naguib
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | | | | | - Amy C Schefler
- Retina Consultants of Houston, Houston, Texas; and
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
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28
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Gegúndez‐Fernández JA, Llovet‐Osuna F, Fernández‐Vigo JI, Mendicute del Barrio J, Pablo‐Júlvez L, Muñoz‐Negrete FJ, Zarranz‐Ventura J, Durán de la Colina J, de Rojas Silva V, Jiménez‐Alfaro I, Calonge‐Cano M, Galindo‐Ferreiro A, Castillo‐Gómez A, Mantolán‐Sarmiento C, Duch‐Samper A, Álvarez de Toledo‐Elizalde J, Duch‐Mestres F, Elies‐Amat D, Ortega‐Usobiaga J, Saornil‐Alvarez MA, Villarrubia Cuadrado A, Garay Aramburu G, Fonollosa Carduch A, Cordero Coma JM, García Delpech S, Cárceles Cárceles JA, Benítez del Castillo Sánchez JM, Gómez de Liaño Sánchez P, Harto Castaño M, Arias Puente A, García‐Layana A. Recommendations for ophthalmologic practice during the easing of COVID-19 control measures. Acta Ophthalmol 2021; 99:e973-e983. [PMID: 33433050 PMCID: PMC8014472 DOI: 10.1111/aos.14752] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022]
Abstract
In the context of the COVID-19 pandemic, this paper provides recommendations for medical eye care during the easing of control measures after lockdown. The guidelines presented are based on a literature review and consensus among all Spanish Ophthalmology Societies regarding protection measures recommended for the ophthalmologic care of patients with or without confirmed COVID-19 in outpatient, inpatient, emergency and surgery settings. We recommend that all measures be adapted to the circumstances and availability of personal protective equipment at each centre and also highlight the need to periodically update recommendations as we may need to readopt more restrictive measures depending on the local epidemiology of the virus. These guidelines are designed to avoid the transmission of SARS-CoV-2 among both patients and healthcare staff as we gradually return to normal medical practice, to prevent postoperative complications and try to reduce possible deficiencies in the diagnosis, treatment and follow-up of the ophthalmic diseases. With this update (5th ) the Spanish Society of Ophthalmology is placed as one of the major ophthalmology societies providing periodic and systematized recommendations for ophthalmic care during the COVID-19 pandemic.
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29
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Rasendran C, Haueisen AJ, Wadhwa R, Singh RP. Geospatial Distribution of Ophthalmologists Older than Age 60 Years Relative to the Prevalence of COVID-19. Ophthalmic Surg Lasers Imaging Retina 2021; 52:556-559. [PMID: 34661463 DOI: 10.3928/23258160-20210930-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate coronavirus disease 2019 (COVID-19) cases as of February 1, 2021 and the proportion of ophthalmologists in the United States older than age 60 years to provide a framework for successful vaccine distribution for the ophthalmology workforce. PATIENTS AND METHODS The Association of American Medical Colleges ophthalmologist workforce dataset (from 2019) for each state was combined with John Hopkins University's COVID-19 tracking data to determine exposure risk for ophthalmologists, especially those older than age 60 years. RESULTS Of the 18,915 practicing ophthalmologists in the US, 37.6% are older than age 60 years. North Dakota (48.4%), Connecticut (46.8%), and Maine (46.7%) have the highest percentages. South Dakota (9,567), Utah (7,559), and Idaho (7,411) currently have the highest COVID-19 exposure burden per ophthalmologist older than age 60 years as of February 1, 2021. CONCLUSION Care must be taken to distribute the COVID-19 vaccine in a safe and proactive manner to ophthalmologists that face high exposure risk, both to ensure physician safety and ensure adequate care for the population they serve. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:556-559.].
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30
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Yener AÜ. COVID-19 and the Eye: Ocular Manifestations, Treatment and Protection Measures. Ocul Immunol Inflamm 2021; 29:1225-1233. [PMID: 34648417 DOI: 10.1080/09273948.2021.1977829] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The novel pandemic coronavirus disease 2019 (COVID-19) leading to health and economic problems worldwide is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although COVID-19 mainly occurs as a lower respiratory tract infection, there is multiorgan involvement in infected patients. The disease is transmitted from person to person through air droplets or contact with contaminated surfaces. SARS-CoV-2 leads to this systemic involvement by attaching to angiotensin-converting enzyme 2 (ACE2) receptors located on several human cells. Since SARS-CoV-2 RNA has been found in tears of infected patients, ocular surface may allow the virus to transmit to nasopharynx via the nasolacrimal duct. This narrative review aims to sum up all segmental ocular complications, ocular adverse effects of COVID-19 treatment, and preventive measures suggested to minimize the SARS-CoV-2 transmission between patients and ophthalmologists by reviewing currently available literature.
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Affiliation(s)
- Arif Ülkü Yener
- Department of Ophthalmology, Keçiören Training and Research Hospital, Ankara, Turkey
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31
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Abstract
PURPOSE OF REVIEW Diabetic retinopathy (DR) is one of the leading causes of vision loss worldwide. Although screening and early treatment guidelines for DR have significantly reduced the disease burden, restrictions related to the COVID-19 pandemic have changed real-world practice patterns in the management of DR. This review summarizes evolving guidelines and outcomes of the treatment of DR in the setting of the pandemic. RECENT FINDINGS Intravitreal injections for DR have decreased significantly globally during the pandemic, ranging from approximately 30 to nearly 100% reduction, compared to corresponding timepoints in 2019. Most studies on functional outcomes show a decrease in visual acuity on delayed follow-up. Changing practice patterns in the management of DR has led to fewer intravitreal injections and overall reduction in visual acuity on follow-up. As COVID variants emerge, it will be necessary to continue evaluating practice guidelines.
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Affiliation(s)
- Ishrat Ahmed
- grid.21107.350000 0001 2171 9311Wilmer Eye Institute, Johns Hopkins University, 600 N. Wolfe Street, Maumenee 726, Baltimore, MD 21287 USA
| | - T. Y. Alvin Liu
- grid.21107.350000 0001 2171 9311Wilmer Eye Institute, Johns Hopkins University, 600 N. Wolfe Street, Maumenee 726, Baltimore, MD 21287 USA
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32
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Pérez-Peralta L, Sauceda-Valenzuela AL, La Parra DRD, Suarez-Ajoleza AA, Beauregard-Escobar AM, Torres-Dominguez JA. Systematic review: SARS-COV-2 contagion prevention measures in vision health professionals. Oman J Ophthalmol 2021; 14:136-143. [PMID: 34880572 PMCID: PMC8597808 DOI: 10.4103/ojo.ojo_134_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/21/2021] [Accepted: 08/12/2021] [Indexed: 11/04/2022] Open
Abstract
The disease, which originated from the SARS-CoV-2 virus, is primarily transmitted by direct contact with infected individuals. Visual healthcare professionals perform clinical practices that pose a significant risk of infection due to their proximity with patients during the examination. This systematic review aims to identify preventive measures that will aid in reducing the risk of infection during standard appointments between patients and visual health professionals. A systematic review was done for articles published in indexed journals from December 2019 to December 2020. The search for these articles was done in 3 electronic databases. As part of the search criteria, articles were selected if they had the keywords (SARS-CoV-2), (COVID-19), and coronavirus combined with ophthalmology, optometry, eye care, and the eye. Once duplicated and unrelated items were eliminated, 36 articles of interest were selected. Seven sections were described in detail: telephone screening, (COVID-19) triage, decreasing transmission within shared spaces, hand washing, use of personal protective equipment Personal Protective Equipment (PPE), cleaning of diagnostic instruments, and use of telemedicine. This paper helps healthcare professionals to better understand the context of the "new normal" clinical practice. Visual health professionals and their patients must adhere to norms and use the indicated PPE during the consultation to safeguard each other.
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Affiliation(s)
- Liliana Pérez-Peralta
- Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
- CAIPaDi, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
| | | | - David Rivera-de La Parra
- Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
- CAIPaDi, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
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Anand SV, Shuy YK, Lee PSS, Lee ES. One Year on: An Overview of Singapore's Response to COVID-19-What We Did, How We Fared, How We Can Move Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179125. [PMID: 34501718 PMCID: PMC8431401 DOI: 10.3390/ijerph18179125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/30/2021] [Accepted: 08/20/2021] [Indexed: 01/28/2023]
Abstract
Background—One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods—This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results—The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion—Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.
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Affiliation(s)
- S Vivek Anand
- Ministry of Health Holdings, Singapore 099253, Singapore;
| | - Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
| | - Poay Sian Sabrina Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
- Correspondence:
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Pathak Ray V, Ramesh SB, Rathi V. Slit-lamp measurement of anterior chamber depth and its agreement with anterior segment optical coherence tomography and Lenstar LS 900 in pseudoexfoliation and normal eyes. Indian J Ophthalmol 2021; 69:2469-2474. [PMID: 34427246 PMCID: PMC8544031 DOI: 10.4103/ijo.ijo_3738_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: There is a considerable lack of awareness of slit-lamp measurement of anterior chamber depth (ACD) by the Redmond Smith method (SACD) in present day-to-day clinical practice, which may provide rapid assessment in pseudoexfoliation (PXF) when assessing for angle closure and planning for cataract surgery. This assumes importance not only in outreach clinics but also in the ongoing pandemic caused by the highly contagious novel coronavirus, where social distancing is advocated to contain the spread. We aimed to compare the axial ACD in PXF and normal patients by SACD, and its agreement with the anterior segment optical coherence tomography (ASOCT) and LenstarLS-900. Methods: A prospective comparative observational study was done at a tertiary eye care hospital. A PXF group and a normal group of controls were recruited. All eyes were phakic with normal cornea. Any eye with previous intraocular/refractive surgery and cause of other secondary or uncontrolled glaucoma was excluded. SACD was measured clinically via slit-lamp method and also via ASOCT and Lenstar; agreement between the methodologies was plotted. Results: Fifty patients were recruited in each group. Mean age was 66.82 ± 4.88 years in PXF patients and 65 ± 5.46 years in controls (P = 0.2). ACD was found to be greater in controls compared with the PXF patients; this difference was statistically significant (P < 0.001) across all methodologies. A good agreement with narrow 95% limits of agreement was found between these methodologies. Conclusion: Redmond Smith slit-lamp methodology of estimating the axial ACD is recommended as a rapid, quantifiable, noncontact screening technique during routine examination, especially in primary outreach centers, and is also advantageous during the ongoing pandemic by reducing expendable investigations.
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Affiliation(s)
- Vanita Pathak Ray
- Department of Glaucoma, Centre for Sight, Banjara Hills, Hyderabad, Telangana, India
| | - Smitha B Ramesh
- L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Varsha Rathi
- GPR-International Centre for Advancement of Rural Eyecare L V Prasad Eye Institute, Hyderabad, Telangana, India
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35
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Biswas J, Kandle K. Does ocular tissue contain SARS CoV-2? Indian J Ophthalmol 2021; 69:2247-2248. [PMID: 34427192 PMCID: PMC8544064 DOI: 10.4103/ijo.ijo_1932_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Jyotirmay Biswas
- Department of Uvea and Ophthalmic Pathology, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Kaustubh Kandle
- Shri Bhagwan Mahavir Department of Vitreo Retina Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
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36
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Tan TE, Chodosh J, McLeod SD, Parke DW, Yeh S, Wong TY, Ting DSW. Global Trends in Ophthalmic Practices in Response to COVID-19. Ophthalmology 2021; 128:1505-1515. [PMID: 34412877 PMCID: PMC8367739 DOI: 10.1016/j.ophtha.2021.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 02/04/2023] Open
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37
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Arruabarrena C, Toro MD, Onen M, Malyugin BE, Rejdak R, Tognetto D, Zweifel S, Giglio R, Teus MA. Impact on Visual Acuity in Neovascular Age Related Macular Degeneration (nAMD) in Europe Due to COVID-19 Pandemic Lockdown. J Clin Med 2021; 10:jcm10153281. [PMID: 34362066 PMCID: PMC8348378 DOI: 10.3390/jcm10153281] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023] Open
Abstract
This is a retrospective, multicenter study of consecutive patients with nAMD scheduled for a visit and/or a treatment with an intravitreal injection (IVI) during the 3 months before lockdown in the Ophthalmology Departments of six centers of Europe.The study was conducted on 546 patients, of which 55.13% were females, almost 100% of the patients were White/Caucasian race, and 71.53% of the patients presented a type 1 macular neovascularization (NVM). A total of 62.82% of patients (343 patients) that were on scheduled clinic visits and/or intravitreal injection treatment during the 3 months before the quarantine did not attend either to visit or for treatment during the lockdown. The mean number of injections during the lockdown was significantly reduced. This was followed by a significant reduction in the mean best-corrected visual acuity (BCVA) between the 3 months before the lockdown (mean BCVA of 60.68 ± 19.77 letters) and 6 months after lockdown (mean BCVA of 56.98 ± 22.59 letters). Patients with better BCVA before the lockdown and the ones showing neovascular activity were more likely to attend their scheduled visits and/or IVI treatments. The COVID-19 pandemic and the lockdown have led to a decrease in the number of IVI treatments in patients with nAMD, evidencing a significant vision loss at 6 months.
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Affiliation(s)
- Carolina Arruabarrena
- Department of Ophthalmology, University Hospital of Alcalá de Henares, Universidad de Alcalá, 28802 Alcalá de Henares, Spain;
- Correspondence: ; Tel.: +34-(91)-8878100
| | - Mario Damiano Toro
- Department of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (M.D.T.); (S.Z.)
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, 01815 Warsaw, Poland
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
| | - Mehmet Onen
- Department of Ophthalmology, Ankara City Hospital, Ankara 06800, Turkey;
| | - Boris E Malyugin
- S. Fyodorov Eye Microsurgery Federal State Institution, Russian Federation, 127486 Moscow, Russia;
| | - Robert Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
| | - Danielle Tognetto
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (D.T.); (R.G.)
| | - Sandrine Zweifel
- Department of Ophthalmology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (M.D.T.); (S.Z.)
| | - Rosa Giglio
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (D.T.); (R.G.)
| | - Miguel A Teus
- Department of Ophthalmology, University Hospital of Alcalá de Henares, Universidad de Alcalá, 28802 Alcalá de Henares, Spain;
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Barabino S. A Narrative Review of Current Understanding and Classification of Dry Eye Disease with New Insights on the Impact of Dry Eye during the COVID-19 Pandemic. Ophthalmol Ther 2021; 10:495-507. [PMID: 34275088 PMCID: PMC8286160 DOI: 10.1007/s40123-021-00373-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/01/2021] [Indexed: 01/18/2023] Open
Abstract
Dry eye disease (DED) is a complex, progressive and multifactorial condition that is commonly seen in clinical practice and can be challenging to accurately diagnose. Untreated or suboptimally managed dry eye can progress to severe, chronic disease which may become resistant to treatment. Symptoms include ocular irritation and visual impairment. Patients frequently report negative consequences regarding quality of life (QoL), productivity and psychological wellbeing. Certain lifestyle factors (e.g. use of screen-based devices, air conditioning) can induce or exacerbate symptoms of DED, leading to progressive and debilitating complications. Exposures to such triggers are likely to have increased significantly during the ongoing COVID-19 pandemic with people across the globe living with heightened levels of stress/anxiety while being forced to adapt most aspects of their daily lives (from work and education through to social activities) to accommodate social distancing, primarily through the use digital technologies. This review aims to provide a concise and practical overview of current understanding regarding DED, highlighting proposals for refined diagnostic categories and therapeutic terminologies that are designed to improve identification and management of dry eye as well as reduce or slow disease progression. Finally, the findings of a European survey are shared to illustrate the impact of the COVID-19 pandemic on the lives of people with DED. The survey was conducted during the first lockdown period (March–September 2020) and explored issues relating to psychological wellbeing, QoL and engagement with healthcare services. The results demonstrate the ways in which the pandemic amplified the impact of dry eye on daily life and may be valuable in enhancing understanding among clinicians of the challenges faced by people with DED, which extend beyond the signs and symptoms of disease.
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Affiliation(s)
- Stefano Barabino
- Centro Superficie Oculare e Occhio Secco, ASST Fatebenefratelli-Sacco, Ospedale L. Sacco, Università di Milano, via G.B. Grassi 74, 20157, Milan, Italy.
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El Asnaoui K, Chawki Y. Using X-ray images and deep learning for automated detection of coronavirus disease. J Biomol Struct Dyn 2021; 39:3615-3626. [PMID: 32397844 PMCID: PMC7256347 DOI: 10.1080/07391102.2020.1767212] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/06/2020] [Indexed: 01/12/2023]
Abstract
Coronavirus is still the leading cause of death worldwide. There are a set number of COVID-19 test units accessible in emergency clinics because of the expanding cases daily. Therefore, it is important to implement an automatic detection and classification system as a speedy elective finding choice to forestall COVID-19 spreading among individuals. Medical images analysis is one of the most promising research areas, it provides facilities for diagnosis and making decisions of a number of diseases such as Coronavirus. This paper conducts a comparative study of the use of the recent deep learning models (VGG16, VGG19, DenseNet201, Inception_ResNet_V2, Inception_V3, Resnet50, and MobileNet_V2) to deal with detection and classification of coronavirus pneumonia. The experiments were conducted using chest X-ray & CT dataset of 6087 images (2780 images of bacterial pneumonia, 1493 of coronavirus, 231 of Covid19, and 1583 normal) and confusion matrices are used to evaluate model performances. Results found out that the use of inception_Resnet_V2 and Densnet201 provide better results compared to other models used in this work (92.18% accuracy for Inception-ResNetV2 and 88.09% accuracy for Densnet201).Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Khalid El Asnaoui
- Complex System Engineering and Human System, Mohammed VI Polytechnic University, Benguerir, Morocco
| | - Youness Chawki
- Faculty of Sciences and Techniques, Moulay Ismail University, Errachidia, Morocco
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El Asnaoui K, Chawki Y. Using X-ray images and deep learning for automated detection of coronavirus disease. J Biomol Struct Dyn 2021; 39:3615-3626. [PMID: 32397844 DOI: 10.1109/access.2020.3010287] [Citation(s) in RCA: 469] [Impact Index Per Article: 156.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Coronavirus is still the leading cause of death worldwide. There are a set number of COVID-19 test units accessible in emergency clinics because of the expanding cases daily. Therefore, it is important to implement an automatic detection and classification system as a speedy elective finding choice to forestall COVID-19 spreading among individuals. Medical images analysis is one of the most promising research areas, it provides facilities for diagnosis and making decisions of a number of diseases such as Coronavirus. This paper conducts a comparative study of the use of the recent deep learning models (VGG16, VGG19, DenseNet201, Inception_ResNet_V2, Inception_V3, Resnet50, and MobileNet_V2) to deal with detection and classification of coronavirus pneumonia. The experiments were conducted using chest X-ray & CT dataset of 6087 images (2780 images of bacterial pneumonia, 1493 of coronavirus, 231 of Covid19, and 1583 normal) and confusion matrices are used to evaluate model performances. Results found out that the use of inception_Resnet_V2 and Densnet201 provide better results compared to other models used in this work (92.18% accuracy for Inception-ResNetV2 and 88.09% accuracy for Densnet201).Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Khalid El Asnaoui
- Complex System Engineering and Human System, Mohammed VI Polytechnic University, Benguerir, Morocco
| | - Youness Chawki
- Faculty of Sciences and Techniques, Moulay Ismail University, Errachidia, Morocco
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Jin YP, Trope GE, El-Defrawy S, Liu EY, Buys YM. Ophthalmology-focused publications and findings on COVID-19: A systematic review. Eur J Ophthalmol 2021; 31:1677-1687. [PMID: 33557602 PMCID: PMC8369910 DOI: 10.1177/1120672121992949] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/17/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE To summarize COVID-19 research endeavors by ophthalmologists/researchers in terms of publication numbers, journals and author countries, and to detail key findings. METHODS The LitCovid database was systematically reviewed for ophthalmology-focused COVID-19 articles. The quality of the evidence was assessed for articles investigating conjunctivitis in COVID-19 patients. RESULTS There were 21,364 articles in LitCovid on June 12, 2020, of which 215 (1%) were ophthalmology-focused. Of articles on COVID-19 transmission, 3.3% were ophthalmology-focused. Ophthalmology-focused articles were published in 68 journals and originated from 25 countries. The top five countries publishing ophthalmology-focused articles (China, India, United States of America, Italy, and United Kingdom) produced 145/215 (67%) articles. A total of 16 case reports/series from eight countries reported that conjunctivitis can be the initial or the only symptom of COVID-19 infection. Conjunctivitis may occur in the middle phase of COVID-19 illness. A total of 10 hospital-based cross-sectional studies reported that between 0% and 31.6% of COVID-19 patients have conjunctivitis or other ocular conditions, with a pooled prevalence of 5.5% reported in a meta-analysis. Viral RNA was detected in conjunctival swabs of patients with and without ocular manifestations, after resolution of conjunctivitis, after nasopharyngeal swabs turned negative and in retina of deceased COVID-19 patients. CONCLUSION Within 3 months of declaring the COVID-19 pandemic, 215 ophthalmology-focused articles were published in PubMed, concentrating on disease manifestations and transmission. The reported presence of conjunctivitis or other ocular conditions in COVID-19 patients is varied. Clinicians should be alert for ocular involvement in COVID-19 infections and possible ocular transmission even in patients without ocular symptoms.
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Affiliation(s)
- Ya-Ping Jin
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Graham E Trope
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Sherif El-Defrawy
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Elin Y Liu
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Toronto, ON, Canada
| | - Yvonne M Buys
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
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Shakaib B, Zohra T, Ikram A, Shakaib MB, Ali A, Bashir A, Salman M, Khan MA, Ansari J. A comprehensive review on clinical and mechanistic pathophysiological aspects of COVID-19 Malady: How far have we come? Virol J 2021; 18:120. [PMID: 34098986 PMCID: PMC8182739 DOI: 10.1186/s12985-021-01578-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/17/2021] [Indexed: 01/08/2023] Open
Abstract
Since its outbreak in 2019, the coronavirus disease (COVID-19) has become a pandemic, affecting more than 52 million people and causing more than 1 million mortalities globally till date. Current research reveals a wide array of disease manifestations and behaviors encompassing multiple organ systems in body and immense systemic inflammation, which have been summarized in this review. Data from a number of scientific reviews, research articles, case series, observational studies, and case reports were retrieved by utilizing online search engines such as Cochrane, PubMed, and Scopus from December 2019 to November 2020. The data for prevalence of signs and symptoms, underlying disease mechanisms and comorbidities were analyzed using SPSS version 25. This review will discuss a wide range of COVID-19 clinical presentations recorded till date, and the current understanding of both the underlying general as well as system specific pathophysiologic, and pathogenetic pathways. These include direct viral penetration into host cells through ACE2 receptors, induction of inflammosomes and immune response through viral proteins, and the initiation of system-wide inflammation and cytokine production. Moreover, peripheral organ damage and underlying comorbid diseases which can lead to short term and long term, reversible and irreversible damage to the body have also been studied. We concluded that underlying comorbidities and their pathological effects on the body contributed immensely and determine the resultant disease severity and mortality of the patients. Presently there is no drug approved for treatment of COVID-19, however multiple vaccines are now in use and research for more is underway.
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Affiliation(s)
- Baila Shakaib
- Rawal Institute of Health Sciences, Islamabad, Pakistan
| | | | - Aamer Ikram
- National Institute of Health, Islamabad, Pakistan
| | | | - Amna Ali
- National Institute of Health, Islamabad, Pakistan
| | - Adnan Bashir
- National Institute of Health, Islamabad, Pakistan
| | | | | | - Jamil Ansari
- National Institute of Health, Islamabad, Pakistan
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Abstract
Background Survey by the commission for cross-sectoral ophthalmology, as a joint commission of the German Ophthalmological Society (DOG) and the Professional Association of German Ophthalmologists (BVA) on the effects of the SARS-CoV‑2 pandemic on ophthalmological patient care in Germany. Methods Online-based survey. Results A total of 1190 questionnaires were (partly) answered. With respect to outpatient care and consultations from 15 March to 15 April 2020, a total of 69 (5.8%) participants indicated unlimited, 756 (63.5%) reduced and 330 (27.7%) emergency care only, independent of the type of institution. Outpatient surgery was restricted to emergency surgery in 68% of clinics, 42.0% of inpatient wards, 45.0% of surgical medical care centers and group practices and 33.0% of private practices. Inpatient procedures were limited to emergency care in 75.0% of inpatient wards and in 71.0% of clinics. With the exception of endophthalmitis (+8.2%), the number of urgent indications and emergencies declined: retinal detachment (−34.8%), perforating eyeball injuries (−7.3%), acute glaucoma (−17.8%), central retinal artery occlusion and anterior ischemic optic neuropathy (−31.0%), others (−30.9%), penetrating keratoplasty and amniotic membrane transplantation (−59.1%). Institutional or professional policy requirements (76.0%) and appointment cancellation by patients (84.0%) were the most common reasons for limitations in ophthalmic patient care. Conclusion The initial phase of the pandemic was characterized by a massive reduction in non-urgent conservative and surgical treatment that affected all areas of ophthalmology. Due to intensive care capacities required for COVID-19 patients, inpatient treatment was largely restricted to emergencies. Treatment of ophthalmological patients, including ocular emergencies and urgent treatment, was maintained across all sectors with a (considerable) decrease in the number of cases even in these groups.
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Almazroa A. Sustainability of Ophthalmology Practice and Training During and Post the Pandemic of Coronavirus (COVID-19): A Review. Clin Ophthalmol 2021; 15:2355-2365. [PMID: 34113079 PMCID: PMC8187105 DOI: 10.2147/opth.s306273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/08/2021] [Indexed: 01/20/2023] Open
Abstract
Purpose To review and analyse the globally established ophthalmic practice protocols during the coronavirus disease (COVID-19). Methods A literature review using search strategy was conducted to identify appropriate publications relevant to COVID-19 and ophthalmology practice and training. The safety and feasibility of the protocols were illustrated and discussed. Results Challenges in different eye care settings at various international ophthalmology departments have identified and analysed to introduce solutions. Several clinical protocols were established and concerned for screening procedures, waiting area, clinical flow (ie, patients' registration, personal (patients and healthcare workers) protection), and equipment safety in the clinics and operation rooms. Discussion In the review of this protocol, the strategic and operational missions of the Academic Medical Centers (AMCs) are demonstrated and discussed. This is in addition to the sustainability of the established protocols for cataract surgeries and glaucoma clinics and training during and after COVID-19. Conclusion All the protocols have established for temporary circumstances, such as postponing elective appointments and surgeries as well as applying the technology for regular follow-ups (transmission of image, video, and face-to-face interactions via widely available applications). Only, one protocol was stronger for the sustainability. Accordingly, recommendations are suggested for clinical sustainability during and after COVID-19.
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Affiliation(s)
- Ahmed Almazroa
- Imaging Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Abstract
ABSTRACT The aim of this article is to review the literature on the impact of coronavirus disease 2019 (COVID-19) on dry eye disease (DED). A literature search on dry eye and COVID-19 was performed. Most current studies focus on DED in patients diagnosed with COVID-19 or dry eye symptoms in random populations of students and medical staff. Real-world dry eye practices revealed a variety of responses, possibly related to local environmental factors and lifestyle. Patients recovered from COVID-19 warrant ocular surface surveillance for DED. Pandemic mitigation strategies including remote work/school/leisure and mask wearing affect dry eye practices globally. Heightened reiteration of dry eye management for environmental and behavioral modifications, visual display terminals, and mask wearing with attention to its effects on the ocular surface is increasingly important as this pandemic continues.
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Affiliation(s)
- Shizuka Koh
- Departments of Innovative Visual Science (S.K.), and Ophthalmology (S.K.), Osaka University Graduate School of Medicine, Osaka, Japan ; and Department of Ophthalmology (M.K.R.), Icahn School of Medicine at Mount Sinai, New York, NY
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Aiello F, Genzano Besso F, Pocobelli G, Gallo Afflitto G, Colabelli Gisoldi RAM, Nucci C, Ponzin D. Corneal transplant during COVID-19 pandemic: the Italian Eye Bank national report. Cell Tissue Bank 2021; 22:697-702. [PMID: 34028630 PMCID: PMC8142289 DOI: 10.1007/s10561-021-09934-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/10/2021] [Indexed: 11/29/2022]
Abstract
To investigate the impact of Coronavirus Disease-2019 lockdown on the Italian Eye Bank organization. In this national retrospective, multicentric, cohort study, data from the Italian Eye Bank during both the lockdown and the first month after the lockdown period were retrieved. We compared the Italian Eye Bank metrics with the same timeframe of 2019 and 2018. Data from 13 out of 13 (100%) Italian Eye Banks were included in the analysis. A statistically significant reduction in the number of donor corneas retrieved in 2020 was found as compared to the same period in 2019 and in 2018, respectively (2020 = 1284; 2019 = 3088; 2018 = 3221; ANOVA: p < 0.0001). Only 534 corneas have been distributed by Eye Banks during the COVID-19-lockdown period (2020 = 534; 2019 = 1220; 2018 = 1237. ANOVA: p < 0.0001). Similarly, the number of wasted corneas due to postponed or cancelled surgeries was 421, resulting in a considerable increase as compared to the previous 2 years (2020 = 421; 2019 = 67; 2018 = 84; ANOVA: p = 0.0035). Overall, 45 donor corneas were rejected in accordance with the guidance of the Italian National Health Institute Italian National Transplant Centre (CNT). SARS-CoV-2 pandemic has profoundly affected every social and medical field, including the Eye Bank procurement and distribution programs. The current data collected from all the Italian Eye Banks highlights the present and the forthcoming difficulties that the Eye Bank community is going to experience, as for the ongoing pandemic.
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Affiliation(s)
- Francesco Aiello
- Ophthalmology Unit. Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | - Federico Genzano Besso
- Eye Bank of Piedmont, SSD Tissue Banks and Biorepository, Città della Salute e della Scienza, Torino, Italy
| | - Giulio Pocobelli
- Ophthalmology Unit. Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Gabriele Gallo Afflitto
- Ophthalmology Unit. Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Carlo Nucci
- Ophthalmology Unit. Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
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Hattenbach LO, Feltgen N, Eter N, Al-Nawaiseh S, Chronopoulos A. Ophthalmic Outpatient and Inpatient Care Under Pandemic Conditions: Hygiene, Triage and New Challenges. Klin Monbl Augenheilkd 2021; 238:561-568. [PMID: 34020484 DOI: 10.1055/a-1487-1742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The progression of the COVID-19 pandemic has caused significant changes in the environment for outpatient and inpatient care in ophthalmology, with limitations on access to medical care but also new observations and challenges. We now describe major developments in recent months and provide an outlook on the expected consequences. METHODS PubMed literature search, clinical survey. RESULTS To date, the course of the COVID-19 pandemic has been characterised by several new but overall rare ocular manifestations, the ophthalmological shared management of COVID-19 patients on intensive care units, and a significant decrease in case numbers, associated with an increase in case severity and relative proportion of emergencies, as a result of delayed presentation of patients and reduced treatment adherence. With the introduction of hygiene measures and infection control procedures, ophthalmic patient care was maintained - including emergencies and urgent treatments. Due to the extensive postponement of elective surgeries, scarce therapeutic and health care professional resources, and the prioritisation of critically ill patients from other specialties, there is a reasonable likelihood that urgent treatments will be delayed as infection rates rise. CONCLUSION Outpatient and inpatient care in ophthalmology during the COVID-19 pandemic is primarily accompanied by additional organisational or medical challenges and a decline in case volume. Although to date emergency and urgent ophthalmic treatments have been maintained, long-term persistence of pandemic conditions will require additional strategies to provide continuation of ophthalmic care at the required level.
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Affiliation(s)
| | | | - Nicole Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
| | - Sami Al-Nawaiseh
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
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Goel H, Wemyss TA, Harris T, Steinbach I, Stancliffe R, Cassels-Brown A, Thomas PBM, Thiel CL. Improving productivity, costs and environmental impact in International Eye Health Services: using the 'Eyefficiency' cataract surgical services auditing tool to assess the value of cataract surgical services. BMJ Open Ophthalmol 2021; 6:e000642. [PMID: 34104796 PMCID: PMC8141432 DOI: 10.1136/bmjophth-2020-000642] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/30/2021] [Accepted: 04/29/2021] [Indexed: 11/25/2022] Open
Abstract
Objective Though one of the most common surgeries, there is limited information on variability of practices in cataract surgeries. ‘Eyefficiency’ is a cataract surgical services auditing tool to help global units improve their surgical productivity and reduce their costs, waste generation and carbon footprint. The aim of the present research is to identify variability and efficiency opportunities in cataract surgical practices globally. Methods and Analysis 9 global cataract surgical facilities used the Eyefficiency tool to collect facility-level data (staffing, pathway steps, costs of supplies and energy use), and live time-and-motion data. A point person from each site gathered and reported data on 1 week or 30 consecutive cataract surgeries. Environmental life cycle assessment and descriptive statistics were used to quantify productivity, costs and carbon footprint. The main outcomes were estimates of productivity, costs, greenhouse gas emissions, and solid waste generation per-case at each site. Results Nine participating sites recorded 475 cataract extractions (a mix of phacoemulsification and manual small incision). Cases per hour ranged from 1.7 to 4.48 at single-bed sites and 1.47 to 4.25 at dual-bed sites. Average per-case expenditures ranged between £31.55 and £399.34, with a majority of costs attributable to medical equipment and supplies. Average solid waste ranged between 0.19 kg and 4.27 kg per phacoemulsification, and greenhouse gases ranged from 41 kg carbon dioxide equivalents (CO2e) to 130 kg CO2e per phacoemulsification. Conclusion Results demonstrate the global diversity of cataract surgical services and non-clinical metrics. Eyefficiency supports local decision-making for resource efficiency and could help identify regional or global best practices for optimising productivity, costs and environmental impact of cataract surgery.
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Affiliation(s)
- Hena Goel
- Population Health, NYU Langone Health, New York, New York, USA
| | - Thomas Alan Wemyss
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Tanya Harris
- Edge Environment, Melbourne, Victoria, Australia
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The Influence of Universal Face Mask Use on Endophthalmitis Risk after Intravitreal Anti-Vascular Endothelial Growth Factor Injections. Ophthalmology 2021; 128:1620-1626. [PMID: 34019955 PMCID: PMC8130590 DOI: 10.1016/j.ophtha.2021.05.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/03/2021] [Accepted: 05/11/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose Routine use of face masks for patients and physicians during intravitreal anti–vascular endothelial growth factor (VEGF) injections has increased with the emergence of the coronavirus disease 2019 pandemic. This study evaluates the impact of universal face mask use on rates and outcomes of post-injection endophthalmitis (PIE). Design Retrospective, multicenter, comparative cohort study. Participants Eyes receiving intravitreal anti-VEGF injections from October 1, 2019, to July 31, 2020, at 12 centers. Methods Cases were divided into a “no face mask” group if no face masks were worn by the physician or patient during intravitreal injections or a “universal face mask” group if face masks were worn by the physician, ancillary staff, and patient during intravitreal injections. Main Outcome Measures Rate of endophthalmitis, microbial spectrum, and visual acuity (VA). Results Of 505 968 intravitreal injections administered in 110 547 eyes, 85 of 294 514 (0.0289%; 1 in 3464 injections) cases of presumed endophthalmitis occurred in the “no face mask” group, and 45 of 211 454 (0.0213%; 1 in 4699) cases occurred in the “universal face mask” group (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.51–1.18; P = 0.097). In the “no face mask” group, there were 27 cases (0.0092%; 1 in 10 908 injections) of culture-positive endophthalmitis compared with 9 cases (0.004%; 1 in 23 494) in the “universal face mask” group (OR, 0.46; 95% CI, 0.22–0.99; P = 0.041). Three cases of oral flora–associated endophthalmitis occurred in the “no face mask” group (0.001%; 1 in 98 171 injections) compared with 1 (0.0005%; 1 in 211 454) in the “universal face mask” group (P = 0.645). Patients presented a mean (range) 4.9 (1–30) days after the causative injection, and mean logarithm of the minimum angle of resolution (logMAR) VA at endophthalmitis presentation was 2.04 (~20/2200) for “no face mask” group compared with 1.65 (~20/900) for the “universal face mask” group (P = 0.022), although no difference was observed 3 months after treatment (P = 0.764). Conclusions In a large, multicenter, retrospective study, physician and patient face mask use during intravitreal anti-VEGF injections did not alter the risk of presumed acute-onset bacterial endophthalmitis, but there was a reduced rate of culture-positive endophthalmitis. Three months after presentation, there was no difference in VA between the groups.
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Breazzano MP, Nair AA, Arevalo JF, Barakat MR, Berrocal AM, Chang JS, Chen A, Eliott D, Garg SJ, Ghadiali Q, Gong D, Grewal DS, Handa JT, Henderson M, Leiderman YI, Leng T, Mannina A, Mendel TA, Mustafi D, de Koo LCO, Patel SN, Patel TP, Prenner J, Richards P, Singh RP, Wykoff CC, Yannuzzi NA, Yu H, Modi YS, Chang S. Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic. JAMA Ophthalmol 2021; 139:456-463. [PMID: 33662093 DOI: 10.1001/jamaophthalmol.2021.0036] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance The American Academy of Ophthalmology (AAO) indicated that urgent or emergent vitreoretinal surgical procedures should continue during the coronavirus disease 2019 (COVID-19) pandemic. Although decreases in the frequency of critical procedures have been reported outside the field of ophthalmology, analyses are limited by volume, geography, and time. Objective To evaluate whether the frequency of ophthalmic surgical procedures deemed urgent or emergent by the AAO changed across the United States during the COVID-19 pandemic. Design, Setting, and Participants Vitreoretinal practices from 17 institutions throughout the US participated in this multicenter cross-sectional study. The frequency of 11 billed vitreoretinal Current Procedural Terminology (CPT) codes across respective weeks was obtained from each practice between January 1, 2019, and May 31, 2020. Data were clustered into intravitreal injections (code 67028), lasers and cryotherapy (codes 67141, 67145, and 67228), retinal detachment (RD) repairs (codes 67107, 67108, 67110, and 67113), and other vitrectomies (codes 67036, 67039, and 67040). Institutions were categorized by region (Northeast, Midwest, South, and West Coast), practice setting (academic [tax-exempt] or private [non-tax-exempt]), and date of respective statewide stay-at-home orders. Main Outcomes and Measures Nationwide changes in the frequency of billing for urgent or emergent vitreoretinal surgical procedures during the COVID-19 pandemic. Results A total of 526 536 CPT codes were ascertained: 483 313 injections, 19 257 lasers or cryotherapy, 14 949 RD repairs, and 9017 other vitrectomies. Relative to 2019, a weekly institutional decrease in injections was observed from March 30 to May 2, 2020, with a maximal 38.6% decrease (from a mean [SD] of 437.8 [436.3] to 273.8 [269.0] injections) from April 6 to 12, 2020 (95% CI, -259 to -69 injections; P = .002). A weekly decrease was also identified that spanned a longer interval, at least until study conclusion (March 16 to May 31, 2020), for lasers and cryotherapy, with a maximal 79.6% decrease (from a mean [SD] of 6.6 [7.7] to 1.5 [2.0] procedures) from April 6 to 12, 2020 (95% CI, -6.8 to -3.3 procedures; P < .001), for RD repairs, with a maximal 59.4% decrease (from a mean [SD] of 3.5 [4.0] to 1.6 [2.2] repairs) from April 13 to 19, 2020 (95% CI, -2.7 to -1.4 repairs; P < .001), and for other vitrectomies, with a maximal 84.3% decrease (from a mean [SD] of 3.0 [3.1] to 0.4 [0.8] other vitrectomies) from April 6 to 12, 2020 (95% CI, -3.3 to -1.8 other vitrectomies; P < .001). No differences were identified by region, setting, or state-level stay-at-home order adjustment. Conclusions and Relevance Although the AAO endorsed the continued performance of urgent or emergent vitreoretinal surgical procedures, the frequency of such procedures throughout the country experienced a substantial decrease that may persist after the COVID-19 pandemic's initial exponential growth phase. This decrease appears independent of region, setting, and state-level stay-at-home orders. It is unknown to what extent vitreoretinal intervention would have decreased without AAO recommendations, and how the decrease is associated with outcomes. Although safety is paramount during the COVID-19 pandemic, practices should consider prioritizing availability for managing high-acuity conditions until underlying reasons for the reduction are fully appreciated.
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Affiliation(s)
- Mark P Breazzano
- Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York.,NYU Langone Eye Center, New York University, New York.,Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Audina M Berrocal
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida
| | - Jonathan S Chang
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison School of Medicine, Madison
| | - Andrew Chen
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Dean Eliott
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Sunir J Garg
- Wills Eye Hospital, Mid-Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Quraish Ghadiali
- Department of Surgery, Cook County Health, Chicago, Illinois.,Retina Consultants Ltd, Chicago, Illinois
| | - Dan Gong
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Dilraj S Grewal
- Department of Ophthalmology, Duke Eye Center, Duke University School of Medicine, Durham, North Carolina
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew Henderson
- NJRetina, Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | | | - Theodore Leng
- Byers Eye Institute of Stanford, Stanford University School of Medicine, Palo Alto, California
| | - Amar Mannina
- Department of Surgery, Cook County Health, Chicago, Illinois
| | | | - Debarshi Mustafi
- Department of Ophthalmology, University of Washington School of Medicine, Seattle
| | - Lisa C Olmos de Koo
- Department of Ophthalmology, University of Washington School of Medicine, Seattle
| | - Shriji N Patel
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tapan P Patel
- Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan Prenner
- NJRetina, Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Paige Richards
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison School of Medicine, Madison
| | - Rishi P Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Nicolas A Yannuzzi
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida
| | - Hannah Yu
- Retina Consultants of Houston, Houston, Texas
| | - Yasha S Modi
- NYU Langone Eye Center, New York University, New York
| | - Stanley Chang
- Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York
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