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Marin-Nieto J, Alba-Linero C, García-Basterra I. Correspondence. Retina 2024; 44:e3-e5. [PMID: 37490768 DOI: 10.1097/iae.0000000000003899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Affiliation(s)
- Juan Marin-Nieto
- Department of Ophthalmology, University Hospital Virgen de la Victoria Málaga, Spain
- Department of Radiology and Physical Medicine. Ophthalmology and Otorhinolaryngology, University of Malaga (UMA), Malaga, Spain
| | - Carmen Alba-Linero
- Department of Ophthalmology, University Hospital Virgen de la Victoria Málaga, Spain
- Department of Radiology and Physical Medicine. Ophthalmology and Otorhinolaryngology, University of Malaga (UMA), Malaga, Spain
| | - Ignacio García-Basterra
- Department of Ophthalmology, University Hospital Virgen de la Victoria Málaga, Spain
- Department of Radiology and Physical Medicine. Ophthalmology and Otorhinolaryngology, University of Malaga (UMA), Malaga, Spain
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Ostrowski P, Masiuk H, Kulig P, Skoryk A, Wcisłek A, Jursa-Kulesza J, Sarna A, Sławiński M, Kotowski M, Tejchman K, Kotfis K, Sieńko J. Medical Face Masks Do Not Affect Acid-Base Balance Yet Might Facilitate the Transmission of Staphylococcus aureus in Hospital Settings during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2474. [PMID: 36767840 PMCID: PMC9915457 DOI: 10.3390/ijerph20032474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Due to the SARS-CoV-2 coronavirus pandemic, the wearing of masks has become a common phenomenon. Most of the undesirable effects of using a protective face covering are usually related to the prolonged time of its wearing, and the adverse consequences of face coverings should be considered two-fold. The aim of the study was to evaluate the rate of contamination of the three types of face coverings (surgical, N95, and FFP2 masks) with the microorganism-aerobic bacteria, yeasts, and molds-after the 3 h exposure time. The study aimed to investigate the effects of wearing FFP2 masks (KN95) on respiratory function and the acid-base balance of the human body. RESULTS The presence of S. aureus was confirmed in both nasal carriers and non-carriers which may demonstrate the cross-contamination and spread of this bacterium via hands. S. aureus was found on external and internal surfaces of face masks of each type, and therefore could also be transmitted via hands from external sources. The 3 h exposure time is not sufficient for Gram-negative rods and mold contamination. Moreover, there were no significant differences in most of the parameters studied between the first and second examinations, both in spirometry and capillary blood gas analysis (p > 0.05).
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Affiliation(s)
- Piotr Ostrowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Helena Masiuk
- Independent Laboratory of Medical Microbiology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Piotr Kulig
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Anastasiia Skoryk
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Aleksandra Wcisłek
- Independent Laboratory of Medical Microbiology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Joanna Jursa-Kulesza
- Independent Laboratory of Medical Microbiology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Angela Sarna
- Department of Laboratory Diagnostics, Public Clinical Hospital No. 2, 70-111 Szczecin, Poland
| | - Michał Sławiński
- Department of Laboratory Diagnostics, Public Clinical Hospital No. 2, 70-111 Szczecin, Poland
| | - Maciej Kotowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Karol Tejchman
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Katarzyna Kotfis
- Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Jerzy Sieńko
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
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Legal obligation in the general population: face mask influence on endophthalmitis after intravitreal injection. Graefes Arch Clin Exp Ophthalmol 2023; 261:97-102. [PMID: 35932321 PMCID: PMC9362425 DOI: 10.1007/s00417-022-05768-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/23/2022] [Accepted: 07/12/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To investigate whether compulsory face masking in public life changes the incidence or pattern of post-injection endophthalmitis (PIE). PATIENTS AND METHODS All injections of bevacizumab, ranibizumab, aflibercept, dexamethasone or triamcinolone between 01/01/2015 and 12/31/2021 at the University Eye Clinic of Tuebingen were included in this retrospective analysis. The injection procedure itself was unchanged since 2015 and included the use of a sterile drape covering the head up to the shoulders which prevents airflow toward the eye. Furthermore, all staff wore a face mask and gloves at all times. The two study periods were defined by the introduction of a compulsory face masking rule in public life (01/01/2015 until 04/27/2020 vs. 04/28/2020 until 12/31/2021). RESULTS A total of 83,543 injections were performed in the tertiary eye clinic, associated with a total of 20 PIE (0.024%, 1/4177 injections). Of these, thirteen PIE were documented during the pre-pandemic period (0.021%, 1/4773 injections) and seven PIE during the pandemic period (0.033%, 1/3071 injections). No significant difference in PIE risk was observed (p = 0.49), and there was no case of oral flora associated PIE. CONCLUSION Although some potential confounders (wearing time, skin flora) could not be considered, there was no clear signal that the introduction of compulsory face masking in public life did alter the risk for PIE in our patient population. Three and six months after PIE, no difference in visual acuity was detectable between the two study periods.
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Burgos-Blasco B, Arriola-Villalobos P, Fernandez-Vigo JI, Oribio-Quinto C, Ariño-Gutierrez M, Diaz-Valle D, Benitez-del-Castillo JM. Face mask use and effects on the ocular surface health: A comprehensive review. Ocul Surf 2023; 27:56-66. [PMID: 36577463 PMCID: PMC9789923 DOI: 10.1016/j.jtos.2022.12.006] [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: 10/20/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 12/26/2022]
Abstract
In the COVID-19 period, face masks increased exponentially. Several studies suggest that the rise in ocular discomfort symptoms during the pandemic is mostly part of dry eye disease and that these are due to the effect of face masks, resulting in the newly described term MADE, for "mask-associated dry eye". The most commonly proposed mechanism states that wearing a face mask creates an unnatural upward airflow towards the ocular surface during expiration, although the increased temperature, humidity and levels of carbon dioxide of the exhaled air, stress, increased use of video display terminals, as well as changes in the ocular microbiota may contribute. Evidence supports that the use of face masks causes an increase in dry eye disease symptoms, a decreased tear break-up time, corneal epithelial trauma, periocular temperature changes and inflammatory markers secretion. Given that the use of masks may be frequent in some settings in the near future, it is important to establish its effects and consequences on the ocular surface.
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Affiliation(s)
- Barbara Burgos-Blasco
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain.
| | - Pedro Arriola-Villalobos
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain,Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid; Madrid, Spain
| | - Jose Ignacio Fernandez-Vigo
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain
| | - Carlos Oribio-Quinto
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain
| | - Mayte Ariño-Gutierrez
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain
| | - David Diaz-Valle
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain,Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid; Madrid, Spain
| | - Jose Manuel Benitez-del-Castillo
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain,Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid; Madrid, Spain
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Tan ACS, Schwartz R, Anaya D, Chatziralli I, Yuan M, Cicinelli MV, Faes L, Mustapha M, Phasukkijwatana N, Pohlmann D, Reynolds R, Rosenblatt A, Savastano A, Touhami S, Vaezi K, Ventura CV, Vogt D, Ambati J, de Smet MD, Loewenstein A. Are intravitreal injections essential during the COVID-19 pandemic? Global preferred practice patterns and practical recommendations. Int J Retina Vitreous 2022; 8:33. [PMID: 35672810 PMCID: PMC9171474 DOI: 10.1186/s40942-022-00380-6] [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: 02/18/2021] [Accepted: 05/01/2022] [Indexed: 11/12/2022] Open
Abstract
Tertiary outpatient ophthalmology clinics are high-risk environments for COVID-19 transmission, especially retina clinics, where regular follow-up is needed for elderly patients with multiple comorbidities. Intravitreal injection therapy (IVT) for chronic macular diseases, is one of the most common procedures performed, associated with a significant burden of care because of the vigorous treatment regimen associated with multiple investigations. While minimizing the risk of COVID-19 infection transmission is a priority, this must be balanced against the continued provision of sight-saving ophthalmic care to patients at risk of permanent vision loss. This review aims to give evidence-based guidelines on managing IVT during the COVID-19 pandemic in common macular diseases such as age-related macular degeneration, diabetic macula edema and retinal vascular disease and to report on how the COVID-19 pandemic has affected IVT practices worldwide. To illustrate some real-world examples, 18 participants in the International Retina Collaborative, from 15 countries and across four continents, were surveyed regarding pre- and during- COVID-19 pandemic IVT practices in tertiary ophthalmic centers. The majority of centers reported a reduction in the number of appointments to reduce the risk of the spread of COVID-19 with varying changes to their IVT regimen to treat various macula diseases. Due to the constantly evolving nature of the COVID-19 pandemic, and the uncertainty about the normal resumption of health services, we suggest that new solutions for eye healthcare provision, like telemedicine, may be adopted in the future when we consider new long-term adaptations required to cope with the COVID-19 pandemic.
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Affiliation(s)
- A C S Tan
- Singapore National Eye Centre, Singapore, Singapore. .,Singapore Eye Research Institute, Singapore, Singapore. .,Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
| | - R Schwartz
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - D Anaya
- Department of Retina, Clínica de Oftalmología de Cali, Valle del Cauca, Colombia
| | - I Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - M Yuan
- Department of Retina, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M V Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Faes
- Moorfields Eye Hospital NHS Foundation Trust, London, UK.,Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - M Mustapha
- Department of Ophthalmology, Universiti Kebangsaan Malaysia, Kulala Lumpur, Malaysia
| | - N Phasukkijwatana
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - D Pohlmann
- Charité - Universitätsmedizin Berlin, FreieUiversität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - R Reynolds
- Department of Ophthalmology, Aneurin Bevan University Health Board, Wales, UK
| | - A Rosenblatt
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - A Savastano
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Touhami
- Department of Ophthalmology, Reference Center in Rare diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - K Vaezi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - C V Ventura
- Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, Brazil.,Department of Ophthalmology, HOPE Eye Hospital, Recife, Brazil
| | - D Vogt
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - J Ambati
- Center for Advanced Vision Science, Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, USA
| | - M D de Smet
- Department of Ophthalmology, Leiden University, Leiden, The Netherlands.,MIOS sa, Lausanne, Switzerland
| | - A Loewenstein
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Safety Measures for Maintaining Low Endophthalmitis Rate after Intravitreal Anti-Vascular Endothelial Growth Factor Injection before and during the COVID-19 Pandemic. J Clin Med 2022; 11:jcm11030876. [PMID: 35160327 PMCID: PMC8837000 DOI: 10.3390/jcm11030876] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/24/2022] [Accepted: 02/03/2022] [Indexed: 02/06/2023] Open
Abstract
During the COVID-19 pandemic, intravitreal injections are performed with patients wearing masks. The risk of endophthalmitis after intravitreal injection is reported to increase due to an influx of exhaled air containing oral bacteria from the upper part of the mask onto the ocular surface. We retrospectively investigated the incidence of endophthalmitis when intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections were performed using the same infection control measures before and during the pandemic. Vitreoretinal specialists performed intravitreal injections of anti-VEGF agents in the outpatient room of a university hospital. Infection control measures before and during the pandemic included covering the patient’s eye with adhesive face drape and irrigating the ocular surface with 0.25% povidone-iodine before draping, and immediately before and after injection. Before the COVID-19 pandemic (February 2016 to December 2019), one case of endophthalmitis occurred among 31,173 injections performed (0.0032%; 95% confidence interval (CI), 0.000008–0.017872%). During the COVID-19 pandemic (January 2020 to August 2021), one case of endophthalmitis occurred among 14,725 injections performed (0.0068%; 95% CI, 0.000017–0.037832%). There was no significant difference between the two periods (Fisher’s exact test: p = 0.5387). Even during the COVID-19 pandemic, very low incidence of endophthalmitis after intravitreal injection can be maintained by implementing basic infection prophylactic measures, including face draping and 0.25% povidone-iodine irrigation, established before COVID-19 pandemic.
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