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Bonilla-Escobar FJ, Sánchez-Cano D, Lasave AF, Soria J, Franco-Cárdenas V, Reviglio VE, Dantas PEC, Palacio Pastrana C, Corbera JC, Chan RY, Diaz AL, Garcia Hernandez M, Maia M, Carpentier C, Wu L, Sanchez M, Murillo Sasamoto M, Murillo Azcárraga G, Roca JA, Serrano MA, Alezzandrini AA, Sanchez Montoya JG, Gabela G, Garcia-Aguirre G, Arevalo JF. Early-Phase Perceptions of COVID-19's Impact on Ophthalmology Practice Patterns: A Survey from the Pan-American Association of Ophthalmology. Clin Ophthalmol 2023; 17:3249-3259. [PMID: 37927574 PMCID: PMC10625333 DOI: 10.2147/opth.s434776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose The COVID-19 pandemic affected medical practice worldwide due to interventions to prevent spreading. Its effect on ophthalmology practices in Latin America has not yet been explored. We aimed to assess the perceptions about the pandemic from countries' ophthalmological national and subspecialty retina societies affiliated to the Pan-American Association of Ophthalmology (PAAO). Patients and Methods A survey-based study of leaders of national ophthalmological and retinal societies was conducted. The survey was sent by email to 30 societies, from which 20 responded (12 countries, 66.6% response rate). It included closed- and open-ended questions about (1) operational capacity and precautions, (2) telemedicine and virtual care, (3) procedures, and (4) post-pandemic considerations. Results There was a marked decline in ophthalmology patient visits (80-95%) and elective surgeries (90%) during 2020 compared to before the pandemic. Precautions like temperature checks, mask usage, and social distancing were widely implemented while personal protective equipment (PPE) availability varied. Telemedicine use was limited due to lack of experience with it. Reopening plans focused on maintaining precautions and gradually resuming activities. Economic and security concerns were raised, and adherence to guidelines was emphasized. Respondents acknowledged the need to adapt to a "new normal". Long duration drugs, fewer imaging studies, and shorter wait times were preferred; however, availability of long duration drugs was limited. Conclusion The pandemic impacted ophthalmology in Latin America, with reduced patient visits, procedures, and surgeries. Delayed treatment and complications were likely the result of the pandemic.
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Affiliation(s)
- Francisco Javier Bonilla-Escobar
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia
- Ophthalmology Department, Institute for Clinical Research Education, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Vision y Salud Ocular, VISOC, Ophthalmology Department, Universidad del Valle, Cali, Colombia
| | - Daniel Sánchez-Cano
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia
| | - Andres F Lasave
- The Retina and Vitreous Department, Private Eyes Clinic, Mar del Plata, Argentina
| | - Jaime Soria
- Ophthalmology Department, Clínica Real Visión, Uniofken, CIVE y Funcrisa, Guayaquil, Ecuador
| | | | - Victor E Reviglio
- Ophthalmology Department, Instituto de la Visión Cerro, Sanatorio Allende Cerro & Universidad Católica de Córdoba, Health Science Faculty, Cordoba, Argentina
| | - Paulo E C Dantas
- Ophthalmology Department, Sorocaba Eye Bank Hospital, Sorocaba, Brazil
| | - Claudia Palacio Pastrana
- Department of Microsurgery of the Anterior Segment, Fundación Hospital Nuestra Señora de la Luz IAP, Mexico City, Mexico
| | | | - Rita Yee Chan
- Ophthalmology Department, Clinica Nacional de Oftalmologia, Panama City, Panama
| | - Alberto Luis Diaz
- Ophthalmology Department, Complejo Medico FOSCAL Internacional, Floridablanca, Santander, Colombia
| | | | - Mauricio Maia
- Ophthalmology Department, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Cristian Carpentier
- Ophthalmology Department, Fundación Oftalmológica Los Andes, Santiago, Chile
| | - Lihteh Wu
- Retina Department, Asociados de Macula Vitreo y Retina de Costa Rica, San Jose, Costa Rica
| | - Martin Sanchez
- Ophthalmology Department, Hospital de Minas, Montevideo, Uruguay
| | | | | | - Jose A Roca
- Ophthalmology Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Martin A Serrano
- Retina Department, Centro Médico Docente La Trinidad, Caracas, Venezuela
| | - Arturo A Alezzandrini
- Ophthalmology Department, OFTALMOS, Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina
| | - Juan Gonzalo Sanchez Montoya
- Ophthalmology Department, Instituto Nacional de Investigacion en Oftalmologia –INIO and Clinica Oftalmologica de Antioquia, Medellin, Colombia
| | - Gregorio Gabela
- Ophthalmology Department, Hospital Metropolitano, Quito, Ecuador
| | - Gerardo Garcia-Aguirre
- Retina Department, School of Medicine, Tecnológico de Monterrey Asociación Para Evitar la Ceguera en México, Mexico City, Mexico
| | - J Fernando Arevalo
- Ophthalmology Department, Johns Hopkins University, Wilmer Eye Institute, Baltimore, MD, USA
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H Fortes B, D Tailor P, T Xu T, A Churchill R, R Starr M. Clinical Characteristics and Outcomes of Endophthalmitis Before and During the COVID-19 Pandemic. J Ophthalmic Vis Res 2023; 18:289-296. [PMID: 37600921 PMCID: PMC10432927 DOI: 10.18502/jovr.v18i3.13777] [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: 11/15/2022] [Accepted: 01/12/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To evaluate the clinical characteristics and visual acuity outcomes of patients who presented with endophthalmitis prior to and during the coronavirus disease 2019 (COVID-19) pandemic. Methods This multicenter retrospective case series with historical controls included consecutive patients presenting with any form of endophthalmitis from March 1, 2019 to September 1, 2019 (pre-COVID-19) and from March 1, 2020 to September 1, 2020 (COVID-19) at Mayo Clinic Rochester (MCR), Health System (MCHS), Arizona (MCA), and Florida (MCF) sites. Cases were divided into "pre-COVID-19" versus "COVID-19" groups depending on when they first presented with endophthalmitis. Results Twenty-eight cases of endophthalmitis presented to all Mayo Clinic sites during the study period. Of these, 10 patients presented during the first six months of the COVID-19 pandemic. During the same six-month period the year prior, 18 patients presented with endophthalmitis. Endophthalmitis etiology (post-injection, post-cataract extraction, post-glaucoma filtering surgery, post-pars plana vitrectomy, endogenous, and others) was similar between both groups (P = 0.34), as was post-injection endophthalmitis rate (P = 0.69), days to presentation (P = 0.07), initial management (P = 0.11), culture-positivity rate (P = 0.70), and need for subsequent pars plana vitrectomy (P = 1). Visual acuity outcomes were similar between both groups at six months, however, the mean LogMAR visual acuity at presentation was worse in the COVID-19 group compared to the pre-COVID-19 group (2.44 vs 1.82; P = 0.026). Conclusion Clinical characteristics and the post-injection endophthalmitis rate were similar during both periods, however, patients presented with worse vision during the pandemic suggesting that the pandemic may have contributed to delayed presentation, regardless, outcomes are still poor.
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Affiliation(s)
- Blake H Fortes
- Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Prashant D Tailor
- Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Timothy T Xu
- Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN, USA
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Ripa M, Sherif A. Cataract surgery training: Report of a trainee's experience. Oman J Ophthalmol 2023; 16:59-63. [PMID: 37007242 PMCID: PMC10062068 DOI: 10.4103/ojo.ojo_128_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/09/2022] [Accepted: 12/02/2022] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND To report a trainee's experience gained in the cataract extraction training program after the COVID-19 pandemic. METHODS An ophthalmologist was trained in phacoemulsification and intraocular lens (IOL) implantation in the ETAPE foundation, Eye Center, Cairo for a period of 4 weeks by three expert cataract surgeons. The training was tailored to the previous trainee's experience according to his residency logbook and supervised by one expert cataract surgeon. The training included didactic lectures, clinical observations, and hands-on practical experience. In addition, the trainee was provided with a logbook to record details of patients operated on and procedures observed. RESULTS The trainee performed 58 phacoemulsification surgery with IOL implantation and two extracapsular cataract extraction over the 4 weeks. Seven patients underwent intraoperative complications. Surgical time (ST) improved from 48.77 ± 9.65 min in the 1stweek to 19.34 ± 1.31 min during the last week of training (P = 0.046). Poisson regression showed that patients affected by less severe cataracts were more likely to exhibit a lower incidence of complications than patients affected by more severe cataracts. In addition, patients operated on during the 1stweek were more likely to show a higher incidence of complications than those operated on during the last week. CONCLUSIONS The 4-week surgical training effectively improved surgical confidence and micro incisional skills according to ST reduction and complication rate occurrence. Ophthalmologists benefit from enhancing their cataract skills in a short time following a well-structured cataract extraction course. This could undoubtedly lead to improved surgical outcomes for patients undergoing cataract extraction.
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Ripa M, Motta L, Schipa C, Rizzo S, Sollazzi L, Aceto P. “Vision Loss” and COVID-19 Infection: A Systematic Review and Meta-Analysis. Vision (Basel) 2022; 6:vision6040060. [PMID: 36278672 PMCID: PMC9589937 DOI: 10.3390/vision6040060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 01/08/2023] Open
Abstract
Background: Visual impairment in terms of reduced visual acuity and “visual loss” has been reported as an atypical symptom in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This systematic review and meta-analysis aims to assess the cumulative incidence of “visual loss” during coronavirus disease 2019 (COVID-19) and review the current evidence regarding “visual loss” caused by SARS-CoV-2 infection. Methods: We performed a systematic review and meta-analysis of studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched the PubMed, Embase, and Scopus databases for relevant studies published that clearly described “vision loss” and SARS-CoV-2 infection. All studies reporting concomitant “vision loss” and laboratory-confirmed SARS-CoV-2 infection were included. Meta-analyses were conducted using the measurement of risk and a 95% confidence interval for each study. Results: Our search identified 1143 manuscripts published in the English language. After study screening, twenty-nine articles were selected: two cross-sectional studies, twenty-four case reports, and three case series. A random-effect meta-analysis demonstrated that the pooled “visual loss” cumulative incidence in COVID-19 patients was 0.16 (95% CI 0.12–0.21). The quality rating of the cross-sectional studies averaged four out of the maximum score on the Newcastle–Ottawa scale. Conclusions: COVID-19 infection might cause “visual loss”. Even if the current evidence is limited, ophthalmological assessment should be promptly provided to all patients experiencing visual impairment symptoms during SARS-CoV-2 infection.
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Affiliation(s)
- Matteo Ripa
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Catholic University “Sacro Cuore”, 00168 Rome, Italy
| | - Lorenzo Motta
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK
| | - Chiara Schipa
- Catholic University “Sacro Cuore”, 00168 Rome, Italy
- Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence:
| | - Stanislao Rizzo
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Catholic University “Sacro Cuore”, 00168 Rome, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, 56127 Pisa, Italy
| | - Liliana Sollazzi
- Catholic University “Sacro Cuore”, 00168 Rome, Italy
- Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Paola Aceto
- Catholic University “Sacro Cuore”, 00168 Rome, Italy
- Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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Facing the Impact of the COVID-19 Pandemic: How Can We Allocate Outpatient Doctor Resources More Effectively? Trop Med Infect Dis 2022; 7:tropicalmed7080184. [PMID: 36006276 PMCID: PMC9416261 DOI: 10.3390/tropicalmed7080184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/04/2022] [Accepted: 08/11/2022] [Indexed: 11/26/2022] Open
Abstract
The COVID-19 pandemic caused significant damage to global healthcare systems. Previous studies regarding COVID-19’s impact on outpatient numbers focused only on a specific department, lacking research data for multiple departments in general hospitals. We assessed differences in COVID-19’s impact on outpatient numbers for different departments to help hospital managers allocate outpatient doctor resources more effectively during the pandemic. We compared the outpatient numbers of 24 departments in a general hospital in Beijing in 2019 and 2020. We also examined an indicator not mentioned in previous studies, monthly departmental patient reservation rates. The results show that, compared with 2019, 2020 outpatient numbers decreased overall by 33.36%. Ten departments’ outpatient numbers decreased >33.36%; however, outpatient numbers increased in two departments. In 2020, the overall patient reservation rate in 24 departments was 82.22% of the 2019 reservation rate; the rates in 14 departments were <82.22%. Moreover, patient reservation rates varied across different months. Our research shows that COVID-19’s impact on different departments also varied. Additionally, our research suggests that well-known departments will be less affected by COVID-19, as will departments related to tumor treatment, where there may also be an increase in patient numbers. Patient reservation rates are an indicator worthy of attention. We suggest that hospital managers classify departments according to changes in outpatient numbers and patient reservation rates and adopt accurate, dynamic, and humanized management strategies to allocate outpatient doctor resources.
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COVID-19 pandemic decreased the ophthalmic outpatient numbers and altered the diagnosis distribution in a community hospital in Taiwan: An observational study. PLoS One 2022; 17:e0264976. [PMID: 35259188 PMCID: PMC8903288 DOI: 10.1371/journal.pone.0264976] [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] [Received: 09/25/2021] [Accepted: 02/19/2022] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to determine the effect of Coronavirus disease 2019 (COVID-19) pandemic on ophthalmic outpatient numbers and ophthalmic diagnosis distribution in a community hospital (Taipei City Hospital Zhongxiao Branch) in Taiwan. The COVID-19 pandemic period in Taiwan was defined as May 1 to July 31, 2021. Demographic data, including age, gender, and top 10 diagnoses from ophthalmic outpatients during this period, were collected. A corresponding control group from the same time in 2020 was also collected. The distribution of different diagnoses was analyzed, and the data of 10 most prominent diagnoses with decreased percentage of case numbers during the COVID-19 pandemic period were obtained. The number of cases during the COVID-19 pandemic decreased by 46.9% compared to the control group. The top three most common diagnoses were dry eye syndrome, glaucoma, and macular diseases. The 10 most prominent diagnoses with decreased number of cases during the COVID-19 pandemic were cataract, refraction & accommodation, macular degeneration, conjunctivitis, retinal detachment, vitreous body disorders, ophthalmic complications of diabetes mellitus, glaucoma, dry eye, and retinal vein occlusion. Identifying and treating these patients as scheduled may yield the highest cost-benefit effect in preventing visual loss during the COVID-19 pandemic.
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