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Ruiss M, Pai V, Pilwachs C, Bayer N, Palkovits S, Findl O. Quality assurance via telephone interviews after cataract surgery: An explorative study. PLoS One 2024; 19:e0298149. [PMID: 38451971 PMCID: PMC10919583 DOI: 10.1371/journal.pone.0298149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/13/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Cataract surgery is a relatively safe procedure with satisfactory postoperative results in most patients. However, in rare cases severe complications can occur shortly after the intervention. Therefore, patients are advised to undergo an ophthalmological examination postoperatively, which should be performed as soon as possible in case of emergencies. However, exactly when these follow-up visits should take place is still discussed. A time- and cost-saving alternative to this could be short-term postoperative telemedical approaches. The aim of this study was to analyze patient complaints as well as satisfaction with and the best timepoint to perform telephone calls after cataract surgery. METHODS Patients scheduled for cataract surgery received a telephone call on the surgery day or the day after (study group) during which they were asked about complaints or additional examination visits. Patients without telephone calls served as control group. All patients had a follow-up visit one week after the intervention during which a questionnaire was filled out and the study group was asked about their satisfaction with the telephone calls. RESULTS 181 patients were recruited in this study. Ocular surface problems were the most common postoperative symptom. More than 80% of the patients were very satisfied with the telephone calls, with patients being contacted on the day of surgery being more calmed than those called on the next day. No difference in additional and planned follow-up visits was found between the study and the control group (P > .40). Postoperative patient complaints (Phi 0.372, P < .001) and additional prescribed therapy (Phi 0.480, P < .001) were moderately associated with additional visits. CONCLUSION Satisfaction with telephone reviews shortly after cataract surgery was very high and contacting patients on the evening of the day of the procedure could be a time- and cost-saving alternative to short-term in-house follow-up visits.
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Affiliation(s)
- Manuel Ruiss
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Viktoria Pai
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Caroline Pilwachs
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Natascha Bayer
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Stefan Palkovits
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Oliver Findl
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
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Zhao D, Li X, Carey AR, Henderson AD. Optic Neuritis and Cranial Neuropathies Diagnosis Rates before Coronavirus Disease 2019, in the Initial Pandemic Phase, and Post-Vaccine Introduction. Ophthalmology 2024; 131:78-86. [PMID: 37634758 DOI: 10.1016/j.ophtha.2023.08.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/04/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023] Open
Abstract
PURPOSE To compare rates of diagnosis of neuro-ophthalmic conditions across the Coronavirus Disease 2019 (COVID-19) pandemic with pre-pandemic levels. DESIGN Multicenter, retrospective, observational study. PARTICIPANTS Patients seen for eye care between March 11, 2019, and December 31, 2021. METHODS A multicenter electronic health record database, Sight Outcomes Research Collaborative (SOURCE), was queried for new diagnoses of neuro-ophthalmic conditions (cranial nerve [CN] III, IV, VI, and VII palsy; diplopia; and optic neuritis) and new diagnoses of other ophthalmic conditions from January 1, 2016, to December 31, 2021. Data were divided into 3 periods (pre-COVID, pre-COVID vaccine, and after introduction of COVID vaccine), with a 3-year look-back period. Logistic regressions were used to compare diagnosis rates across periods. Two-sample z-test was used to compare the log odds ratio (OR) of the diagnosis in each period with emergent ocular conditions: retinal detachment (RD) and acute angle-closure glaucoma (AACG). MAIN OUTCOME MEASURES Diagnosis rate of neuro-ophthalmic conditions in each study period. RESULTS A total of 323 261 unique patients (median age 59 years [interquartile range, 43-70], 58% female, 68% White) across 5 academic centers were included, with 180 009 patients seen in the pre-COVID period, 149 835 patients seen in the pre-COVID vaccine period, and 164 778 patients seen in the COVID vaccine period. Diagnosis rates of CN VII palsy, diplopia, glaucoma, and cataract decreased from the pre-COVID period to the pre-vaccine period. However, the optic neuritis diagnoses increased, in contrast to a decrease in RD diagnoses (P = 0.021). By comparing the diagnosis rates before and after widespread vaccination, all eye conditions evaluated were diagnosed at higher rates in the COVID vaccination period compared with pre-COVID and pre-vaccine periods. The log OR of neuro-ophthalmic diagnosis rates across every period comparison were largely similar to emergency conditions (RD and AACG, P > 0.05). However, the log OR of cataract and glaucoma diagnoses were different to RD or AACG (P < 0.05) in each period comparison. CONCLUSIONS Neuro-ophthalmic diagnoses had a similar reduction in diagnosis rates as emergent eye conditions in the first part of the pandemic, except optic neuritis. After widespread COVID-19 vaccination, all ophthalmic diagnosis rates increased compared with pre-pandemic rates, and the increase in neuro-ophthalmic diagnosis rates did not exceed the increase in RD and AACG diagnosis rates. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- David Zhao
- Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland.
| | - Ximin Li
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Zhou H, Liao R, Zhang D, Wang W, Deng S. Glaucoma Characteristics and Influencing Factors during the COVID-19 Pandemic in the Huizhou Region. J Ophthalmol 2023; 2023:8889754. [PMID: 37927894 PMCID: PMC10622592 DOI: 10.1155/2023/8889754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Glaucoma in individuals who tested positive for the coronavirus disease 2019 (COVID-19) during the pandemic outbreak has not been comprehensively studied. Therefore, this study aimed to analyze the characteristics and risk factors of glaucoma during the COVID-19 pandemic in Huizhou. Methods Retrospective data from outpatients with glaucoma at the Huizhou Hospital Affiliated with Guangzhou Medical University and Longmen County People's Hospital were collected during two periods: the COVID-19 pandemic period (Phase A: December 1, 2022, to January 19, 2023) and the prevention and control period (Phase B: December 1, 2021, to January 19, 2022). The demographic characteristics of the outpatients during both phases were compared. The characteristics of glaucoma in patients with COVID-19 during Phase A were examined. Multivariate logistic regression analysis was used to identify factors influencing the development of acute angle-closure glaucoma (AACG) in Phase A patients. Results The proportion of patients with glaucoma was significantly higher during Phase A than during Phase B at both hospitals. No statistically significant differences were observed between patients with glaucoma during Phases A and B for age, sex, and region. A high COVID-19-positive rate was associated with old age, females, AACG, newly diagnosed glaucoma, and binocular involvement during phase A. Females testing positive for COVID-19, glaucoma that started after testing positive for COVID-19, and a history of medication use were associated with a higher proportion of AACG in phase A. Multivariable logistic regression analysis identified testing positive for COVID-19 as an independent potential risk factor for developing AACG. Conclusion In summary, during the COVID-19 pandemic in Huizhou, patients with COVID-19 were primarily affected by AACG, especially females, older individuals, and those with binocular involvement. Testing positive for COVID-19 increases the risk of developing AACG.
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Affiliation(s)
- Huilan Zhou
- Huizhou Hospital Affiliated to Guangzhou Medical University (Huizhou Third People's Hospital), Huizhou 516000, Guangdong, China
| | - Rui Liao
- Huizhou Hospital Affiliated to Guangzhou Medical University (Huizhou Third People's Hospital), Huizhou 516000, Guangdong, China
| | - Dongxuan Zhang
- Huizhou Hospital Affiliated to Guangzhou Medical University (Huizhou Third People's Hospital), Huizhou 516000, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510000, Guangdong, China
| | - Shuifeng Deng
- Huizhou Hospital Affiliated to Guangzhou Medical University (Huizhou Third People's Hospital), Huizhou 516000, Guangdong, China
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Mousavi M, Kahuam-López N, Iovieno A, Yeung SN. Global impact of COVID-19 on corneal donor tissue harvesting and corneal transplantation. Front Med (Lausanne) 2023; 10:1210293. [PMID: 37608828 PMCID: PMC10440952 DOI: 10.3389/fmed.2023.1210293] [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: 04/22/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Introduction The purpose of this review is to consolidate and examine the available literature on the coronavirus disease 2019 pandemic and its effect on corneal transplantation and eye banking. Methods A primary literature search was conducted using the PubMed (Medline) database with keywords and MeSH terms such as "corneal transplantation," "eye banks," "keratoplasty" and then were combined with COVID-19. Relevant articles through September 2022 were assessed and 25 articles were included in this review. Results Donor tissue volumes declined globally during lockdown periods due to a lower number of referrals and tighter tissue screening guidelines. Rates of elective surgeries decreased in the lockdown period compared to respective periods in previous years. However, changes in rates of emergency procedures were not uniform across different regions. Moreover, rates of different elective corneal grafts [i.e., penetrating keratoplasty (PK), endothelial keratoplasty (EK), or anterior lamellar keratoplasty (ALK)] were affected differently with the pattern of change being dependent on region-specific factors. Conclusion Both donor tissue volumes and rates of corneal transplant procedures were affected by lockdown restrictions. The underlying etiology of these changes differed by region. Examining the range of impact across many countries as well as the contributing factors involved will provide guidance for future global pandemics.
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Affiliation(s)
| | | | | | - Sonia N. Yeung
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
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Liu J, Ye Q, Xiao C, Zhuang Y, Feng L, He Y, Xu Z, Zhou Y, Chen X, Yao Y, Jiang R, Pang Y, Yu W, Wen Y, Yuan J, Thompson B, Li J. Impact of COVID-19 pandemic control measures on amblyopia treatment: a retrospective study of records from a tertiary eye hospital in China. BMJ Open 2023; 13:e071839. [PMID: 37407054 PMCID: PMC10335509 DOI: 10.1136/bmjopen-2023-071839] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES Amblyopia is the most common cause of unilateral visual impairment in children and requires long-term treatment. This study aimed to quantify the impact of pandemic control measures on amblyopia management. DESIGN AND SETTING This was a retrospective cohort study of data from a large amblyopia management database at a major tertiary eye care centre in China. PARTICIPANTS Outpatients with amblyopia who visited the hospital from 1 June 2019, through 28 February 2022. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the number of first and follow-up in-person visits to the hospital for amblyopia treatment. Secondary outcomes included the time interval between consecutive visits and improvement of vision (visual acuity, contrast sensitivity and stereopsis). Patient records were grouped into prepandemic and during pandemic periods. RESULTS A total of 10 060 face-to-face visits for 5361 patients (median age 6.7 years, IQR 5.4, 8.9) that spanned two lockdown periods were included in the analysis, of which 28% were follow-up visits. Pandemic control measures caused a sharp decline in the number of outpatient visits (3% and 30% of prepandemic levels in the months directly after the start of the first (2020) and second (2021) periods of pandemic control measures, respectively). However, these drops were followed by pronounced rebounds in visits that exceeded prepandemic levels by 51.1% and 108.5%, respectively. The interval between consecutive visits increased significantly during the pandemic from a median (IQR) of 120 (112, 127) days in 2019 to 197 (179, 224) in 2020 (p<0.001) and 189 (182, 221) in 2021 (p<0.001). There were no significant differences in the improvement of visual function or treatment compliance between the prepandemic and postpandemic groups. CONCLUSIONS The number of amblyopia patient hospital visits spiked well above prepandemic levels following lockdown periods. This pattern of patient behaviour can inform planning for amblyopia treatment services during and after public health-related disruptions.
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Affiliation(s)
- Jing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Qingqing Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Chutong Xiao
- Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, California, USA
| | - Yijing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Lei Feng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Yunsi He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Zixuan Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Yusong Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Xiaolan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Ying Yao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Rengang Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Yangfei Pang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Wentong Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Yun Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Junpeng Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
| | - Benjamin Thompson
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Jinrong Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center,Sun Yat-Sen University, Guangzhou, China
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Jayallan B, Ngah NF, Hussain NI, Nik Jaafar NR, Aizuddin AN, Yong MH, Md Din N, Bastion MLC. Impact of Postponement of Appointments on Vision and Psychological Well-Being Among Outpatients Attending Ophthalmology Clinics: A Malaysian Perspective. Cureus 2023; 15:e38423. [PMID: 37273393 PMCID: PMC10233503 DOI: 10.7759/cureus.38423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, non-frontline medical disciplines, including ophthalmology, were advised to minimize their services to channel crucial healthcare resources to manage the surge in COVID-19 cases. The ophthalmology department postponed all non-urgent appointments and elective surgical procedures. However, little is known about the visual and mental health impact of these changes in ophthalmology services. Therefore, our study aimed to explore the impact of postponement in ophthalmology outpatient clinic appointments towards visual acuity (VA) changes and the psychological well-being of patients during the COVID-19 pandemic in Malaysia. METHODOLOGY This cross-sectional study, utilizing a convenience sampling method, recruited patients attending ophthalmology outpatient clinic services from July 2020 to June 2021 to participate in the study. The Snellen chart was used to measure the VA, and the Kessler psychological distress scale (K-10) was used to measure psychological distress levels among patients with (study) and without (controls) postponement of the appointment. Results: A total of 485 patients were included in the data analysis; 267 study and 218 controls. There is a statistically significant difference in categorical change of VA (p < 0.001) and categorical K-10 score (p = 0.048) among the study and control groups. Nonetheless, a decline in VA alone does not show a statistically significant association with an increased probability of experiencing psychological distress (p=0.149). CONCLUSION Postponement of ophthalmology appointments negatively affected the VA and the psychological well-being of patients. Appropriate assessment of patients before postponing their appointment is crucial to mitigate the worsening of VA and psychological distress.
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Affiliation(s)
- Bannu Jayallan
- Department of Ophthalmology, Hospital Canselor Tunku Mukhriz Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Nor Fariza Ngah
- Department of Ophthalmology, Hospital Shah Alam, Selangor, MYS
| | | | - Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Hospital Canselor Tunku Mukhriz Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Azimatun Noor Aizuddin
- Department of Research and Statistics, Hospital Canselor Tunku Mukhriz Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Meng Hsien Yong
- Department of Ophthalmology, Hospital Canselor Tunku Mukhriz Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Norshamsiah Md Din
- Department of Ophthalmology, Hospital Canselor Tunku Mukhriz Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Mae-Lynn Catherine Bastion
- Department of Ophthalmology, Hospital Canselor Tunku Mukhriz Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
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Baudin F, Benzenine E, Mariet AS, Ben Ghezala I, Daien V, Gabrielle PH, Quantin C, Creuzot-Garcher CP. Impact of COVID-19 lockdown on surgical procedures for retinal detachment in France: a national database study. Br J Ophthalmol 2023; 107:565-569. [PMID: 34799368 PMCID: PMC8609492 DOI: 10.1136/bjophthalmol-2021-319531] [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: 04/26/2021] [Accepted: 11/06/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS The COVID-19 crisis and the decisions made regarding population lockdown may have changed patient care. We aimed to investigate the incidence rate of rhegmatogenous retinal detachment (RRD) cases during the COVID-19 lockdown period. METHODS In this nationwide database study, we identified hospital and clinic admissions of French residents for a first episode of RRD in France from 2017 to the lockdown period in 2020. The monthly hospital incidence rates of RRD procedures per 100 000 inhabitants before, during and after lockdown were computed for the whole country. Finally, we assessed the influence of viral incidence on the RRD incidence rate, comparing two regions with highly contrasting viral penetration. RESULTS From January to July, the average monthly national hospital incidence rate of RRD decreased from a mean of 2.59/100 000 inhabitants during 2017-2019 to 1.57/100 000 inhabitants in 2020. Compared with 2019, during the 8-week lockdown period in 2020, a 41.6% decrease in the number of RRD procedures was observed (p<0.001) with the weekly incidence of RRD decreasing from 0.63/100 000 inhabitants in 2019 to 0.36/100 000 inhabitants. During the 4-month post-lockdown period, no increased activity related to postponed procedures was observed. No difference was found in the rate of RRD surgery when comparing two regions with highly contrasting viral incidence. CONCLUSION Containment may have been responsible for a decrease in the number of surgical procedures for RRD, without any compensating post-lockdown activity in France. These results might help increase awareness of the management of RRD emergencies.
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Affiliation(s)
- Florian Baudin
- Ophthalmology, University Hospital Centre Dijon, Dijon, France
- Équipe d'Accueil (EA 7460): Physiopathologie et Épidémiologie Cérébro-Cardiovasculaires (PEC2), Burgundy Franche-Comté University, Dijon, France
| | - Eric Benzenine
- Biostatistics and Bioinformatics (DIM), University Hospital Centre Dijon, Dijon, France
| | - Anne-Sophie Mariet
- Biostatistics and Bioinformatics (DIM), University Hospital Centre Dijon, Dijon, France
- Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, INSERM CIC1432, University Hospital Centre Dijon, Dijon, France
| | - Inès Ben Ghezala
- Ophthalmology, University Hospital Centre Dijon, Dijon, France
- Équipe d'Accueil (EA 7460): Physiopathologie et Épidémiologie Cérébro-Cardiovasculaires (PEC2), Burgundy Franche-Comté University, Dijon, France
| | - Vincent Daien
- Ophthalmology, University Hospital Montpellier, Montpellier, France
- Epidemiology, INSERM, U1061, Montpellier, France
| | - Pierre-Henry Gabrielle
- Ophthalmology, University Hospital Centre Dijon, Dijon, France
- Eye and Nutrition Research Group, Taste and Food Science Center, Burgundy Franche-Comté University, Dijon, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital Centre Dijon, Dijon, France
- Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, INSERM CIC1432, University Hospital Centre Dijon, Dijon, France
| | - Catherine P Creuzot-Garcher
- Ophthalmology, University Hospital Centre Dijon, Dijon, France
- Eye and Nutrition Research Group, Taste and Food Science Center, Burgundy Franche-Comté University, Dijon, France
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Bajka A, Muth DR, Wiest MRJ, Said S, Rejdak M, Sidhu S, Foa N, Blaser F, Barthelmes D, Toro MD, Souied EH, Deuel JW, Schlagenhauf P, Zweifel SA. Analysis of Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA) Parameters in Young Adults after SARS-CoV-2 Infection (COVID-19) Compared with Healthy Young Controls. Diagnostics (Basel) 2023; 13:diagnostics13071283. [PMID: 37046498 PMCID: PMC10093659 DOI: 10.3390/diagnostics13071283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Purpose: To compare retinal changes in young adults with previous SARS-CoV-2 infection with healthy young controls using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods: This prospective single-center study was conducted at the University Hospital of Zurich, Zurich, Switzerland. Participants were imaged from May to November 2021 using the SOLIX device (Visionix International SAS, Pont-de-l’Arche, France). We performed 12 mm × 12 mm, 6.4 mm × 6.4 mm, 6 mm × 6 mm and 3 mm × 3 mm OCT and OCTA scans, as well as fundus photography of each participant’s eyes. Results: In total, 466 participants were imaged. Of these, 233 were healthy controls with negative RT-PCR tests for SARS-CoV-2, 168 were young adults who had a SARS-CoV-2 infection at least 180 days previously, 19 were participants who had a SARS-CoV-2 infection < 180 days previously, and 46 were participants with asymptomatic SARS-CoV-2 infection (i.e., serologically positive but with no symptoms). Compared with healthy controls, statistically significant differences were found for OCTA recordings of the optic disc for the whole image (WI) and WI capillary vessel density, with both being higher in the SARS-CoV-2 group. Conclusion: Statistically significant results were only observed for selected variables, and in parts, only unilaterally, with relatively large p values (p = 0.02–0.03). Thus, we did not interpret these as clinically significant, leading to the conclusion that young and otherwise healthy individuals (mainly men) seem to recover from mild COVID-19 infections with no ophthalmological residues.
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Affiliation(s)
- Anahita Bajka
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Daniel Rudolf Muth
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | | | - Sadiq Said
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Magdalena Rejdak
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Sophia Sidhu
- Faculty of Medicine, University of California, San Diego, CA 92093, USA
| | - Nastasia Foa
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Frank Blaser
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Daniel Barthelmes
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Mario Damiano Toro
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
- Eye Clinic, Public Health Department, University of Naples Federico II, 80138 Naples, Italy
| | - Eric H. Souied
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, University Paris Est Creteil, 94000 Creteil, France
| | - Jeremy Werner Deuel
- Department of Global and Public Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
- Division of Medical Oncology and Haematology, University Hospital of Zurich, 8006 Zurich, Switzerland
| | - Patricia Schlagenhauf
- Department of Global and Public Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
- MilMedBiol—Centre of Competence for Military Medicine Biology, University of Zurich, 8006 Zurich, Switzerland
| | - Sandrine Anne Zweifel
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
- Correspondence: ; Tel.: +41-44-255-87-94
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Hurand V, Ducloyer J, Baudin F, Aho S, Weber M, Kodjikian L, Devin F, Gabrielle P, Creuzot‐Garcher C, Massin P. IMPACT study: Impact of adherence to anti-VEGF intravitreal injections for macular disease during COVID 19-related confinement in France. Acta Ophthalmol 2023; 101:91-99. [PMID: 35765939 PMCID: PMC9350166 DOI: 10.1111/aos.15206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/23/2022] [Accepted: 06/05/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of this study was to evaluate the impact of adherence to French coronavirus disease 2019 (COVID 19)-related guidelines for intravitreal injection (IVI) practice on the visual outcomes of patients treated with anti-vascular endothelial growth factor (VEGF) agents for macular diseases during the first lockdown period. METHODS Observational multicentre study including all patients from 18 centres with an IVI initially planned during the lockdown. Visual acuity (VA, ETDRS) was recorded at 1 and 4 months after lockdown. French COVID 19-related guidelines recommended maintaining IVI practice. We defined three groups of patients: A, adherent to guidelines; NA+, non-adherent with delayed IVIs; and NA-, non-adherent without IVIs performed during the lockdown. Risk factors for non-adherence and visual loss were studied. RESULTS A total of 3020 eyes of 3020 patients, aged 77.8 ± 11.6 years, 59.8% women, were included. 59.3% were non-adherent(46.7% NA+, 12.6% NA-). A smaller decrease in VA at 4 months was observed in the A group than the NA+ and NA- group (-0.2 ± 6.7, -0.3 ± 6.9 and -1.5 ± 6.9, respectively [p < 0.001]). Factors associated with non-adherence were in multivariable analysis, older age, hospital practice, low-density population areas, high viral incidence areas, longer intervals between injection and treat and extent protocol. Factors associated with visual loss at 4 months in multivariable analysis were, being in the NA- group, older age, T&E and fixed regimens. CONCLUSION Strict adherence to guidelines was associated with better visual outcome, although most of our patients did not attend as planned. Identification of patients at risk could help in the future in case of a new pandemic lockdown.
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Affiliation(s)
| | | | - Florian Baudin
- Department of OphthalmologyUniversity HospitalDijonFrance
- Pathophysiology and Epidemiology of Cerebro‐Cardiovascular Diseases (PEC2)University HospitalDijonFrance
| | - Serge Aho
- Department of EpidemiologyUniversity HospitalDijonFrance
| | - Michel Weber
- Department of OphthalmologyUniversity HospitalNantesFrance
| | - Laurent Kodjikian
- Department of OphthalmologyCroix Rousse University HospitalLyon 4France
| | - François Devin
- Center of Ophthalmology Monticelli ParadisMarseilleFrance
| | - Pierre‐Henry Gabrielle
- Department of OphthalmologyUniversity HospitalDijonFrance
- Eye and Nutrition Research GroupGSGA, INRAeBurgundy, DijonFrance
| | - Catherine Creuzot‐Garcher
- Department of OphthalmologyUniversity HospitalDijonFrance
- Eye and Nutrition Research GroupGSGA, INRAeBurgundy, DijonFrance
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10
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Sidhu JK, Yaakub A, Ahmad Tajudin LS. Lockdown: The Impact on Management of Glaucoma in a Suburban Tertiary Centre in Malaysia. Cureus 2023; 15:e34412. [PMID: 36874736 PMCID: PMC9980875 DOI: 10.7759/cureus.34412] [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] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic brought the world to a standstill in 2020. Many countries have imposed lockdowns, known as the movement-control order (MCO) in Malaysia, to prevent transmission of the disease. AIM The objective of this study is to evaluate the impact of the MCO on the management of glaucoma patients in a suburban tertiary hospital. METHODOLOGY We conducted a cross-sectional study of 194 glaucoma patients between June 2020 and August 2020 in the glaucoma clinic at Hospital Universiti Sains Malaysia. We evaluated the patients' treatment, visual acuity, intraocular pressure (IOP) measurements, and potential signs of progression. We compared the results with those of their last clinic visits prior to the MCO. RESULTS We studied 94 (48.5%) male and 100 (51.5%) female glaucoma patients with a mean age of 65 ± 13.7. The mean duration between pre-MCO and post-MCO follow-up was 26.4 ± 6.7 weeks. There was a significant increase in the number of patients with deterioration of visual acuity, and one patient lost his vision after the MCO. There was also a significant elevation of the mean IOP of the right eye: pre-MCO, 16.7 ± 7.8 mmHg, compared to post-MCO, 17.7 ± 8.8 mmHg (p = 0.027). The cup-to-disc ratio (CDR) for the right eye increased significantly from pre-MCO, 0.72 ± 0.18, to 0.74 ± 0.19 post-MCO (p < 0.001). However, there were no significant changes in IOP or CDR in the left eye. Twenty-four patients (12.4%) missed medications during the MCO period, and 35 patients (18%) required additional topical medications due to the progression of the disease. Only one patient (0.5%) required admission due to uncontrolled IOP. CONCLUSION Lockdown, as a preventive step in the COVID-19 pandemic, indirectly caused the progression of glaucoma and uncontrolled IOP.
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Affiliation(s)
- Jasvinjeet K Sidhu
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MYS.,Ophthalmology Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, MYS
| | - Azhany Yaakub
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MYS.,Ophthalmology Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, MYS
| | - Liza Sharmini Ahmad Tajudin
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MYS.,Ophthalmology Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, MYS
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11
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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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12
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Yadav M, Tanwar M. Impact of COVID-19 on glaucoma management: A review. FRONTIERS IN OPHTHALMOLOGY 2022; 2:1003653. [PMID: 38983512 PMCID: PMC11182257 DOI: 10.3389/fopht.2022.1003653] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/23/2022] [Indexed: 07/11/2024]
Abstract
Glaucoma is the leading cause of irreversible vision loss and the second leading cause of blindness worldwide. The rapid transmission of SARS-CoV-2virus compelled governments to concentrate their efforts on emergency units to treat the large number of cases that arose due to the Covid-19 outbreak. As a result, many chronically ill patients were left without access to medical care. The progression of glaucoma in previously diagnosed cases has been accelerated; due to this, some have lost their vision. Evaluation of Covid-19's effect on glaucoma treatment was one goal of this study. We used search phrases like "COVID-19," "telemedicine," and "glaucoma" to find published papers on COVID-19 and glaucoma. Artificial Intelligence (AI) may be the answer to the unanswered questions that arose due to this pandemic crisis. The benefits and drawbacks of AI in the context of teliglaucoma have been thoroughly examined. These AI-related ideas have been floating around for some time. We hope that Covid-19's enormous revisions will provide them with the motivation to move forward and significantly improve services. Despite the devastation the pandemic has caused, we are hopeful that eye care services will be better prepared and better equipped to avoid the loss of sight due to glaucoma in future.
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Affiliation(s)
| | - Mukesh Tanwar
- Department of Genetics, Maharshi Dayanand University, Rohtak, India
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13
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Kim K, Kim ES, Kim DG, Yu SY. The effect of intravitreal dexamethasone implantation on diabetic macular edema refractory to anti-vascular endothelial growth factor treatment. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2118715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Kiyoung Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Eung Suk Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Do Gyun Kim
- Department of Ophthalmology, Myongji Hospital, Hanyang University Medical Center, Goyang-si, South Korea
| | - Seung-Young Yu
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
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14
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Kumar A, Tewari AS. Risk Identification of Diabetic Macular Edema Using E-Adoption of Emerging Technology. INTERNATIONAL JOURNAL OF E-ADOPTION 2022. [DOI: 10.4018/ijea.310000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The accumulation of the blood leaks on the retina is known as diabetic macular edema (DME), which can result in irreversible blindness. Early diagnosis and therapy can stop DME. This study presents an e-adoption of emerging technology such as RadioDense model for detecting and classifying DME from retinal fundus images. The proposed model employs a modified version of DenseNet121, radiomics features, and the gradient boosting classifier. The authors evaluated many classifiers on the concatenated features. The efficacy of the classifier is determined by comparing each classifier's accuracy values. According to the evaluation results, the concatenated features extraction using gradient boosting classifier outperforms all other classifiers on the IDRiD dataset. For multi-class classification, the suggested electronic adoption of emerging technology such as RadioDense model outperformed these classifiers and attained an accuracy of 87.4%. It can help to decrease the strain of ophthalmologists diagnosing the DME during locking and unlocking the worldwide lockdown.
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Affiliation(s)
- Amit Kumar
- National Institute of Technology, Patna, India
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15
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Ophthalmologic emergency room visits during COVID-19 lockdown–Characterization from Haifa, Israel. PLoS One 2022; 17:e0273033. [PMID: 35984780 PMCID: PMC9390934 DOI: 10.1371/journal.pone.0273033] [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: 08/12/2021] [Accepted: 08/01/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose To characterize quantitative differences among ophthalmologic emergency room (OER) encounters at Rambam Health Care Campus during a 6-week complete lockdown at the peak of the first COVID-19 wave as compared to a corresponding uneventful period a year earlier. Methods A retrospective chart analysis of all OER encounters during the lockdown and non-lockdown period was conducted. Patients were stratified into primary ophthalmological conditions (OER visits) and cases in which ophthalmologic consultations were requested by a non-ophthalmologist (OER consultations). The following parameters were compared: total number of cases, age, gender, chief complaint/diagnosis categorized into major entities, and discharge vs. hospitalization. For continuous variables a t-test was used and for categorical variables a chi-squared or Fisher’s exact test was used. A 2-sided p value <0.05 was considered statistically significant. Results The total number of patients in the lockdown and non-lockdown groups was 486 and 992, respectively, showing a 51% decrease in visits during lockdown. In the non-lockdown and lockdown groups 56% and 61% of patients were male (p = 0.07), with an average age of 42 (range 0–97, SD 23) and 43 (range 0–90, SD 22) years, respectively (p = 0.44). No statistically significant proportional increase was found for any diagnostic category between the OER visits (p = 0.07) and OER consultation groups (p = 0.77). Nevertheless, analysis revealed a non-significant increase in the proportion of eye trauma from 14.8% to 21.2%, and reduction in eyelid conditions from 10.7% to 5.8%. The total number of OER visits demanding urgent intervention on admission was 43 (non-lockdown) and 24 (lockdown), while hospitalization ratio (hospitalizations/visits) was 8.8% and 10.6%, respectively (p = 0.44). Conclusions During the COVID-19 lockdown the guideline for patients in Israel was to avoid unnecessary hospital visits. Since patients tended to avoid the OER rather uniformly regardless of their specific eye condition, determining the risk-benefit of such recommendations and identifying high-risk sub-populations are critical public health issues.
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16
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Taghioff SM, Slavin BR, Narasimman M, Samaha G, Samaha M, Holton T, Singh D. The influence of SARS-CoV-2 vaccination on post-operative outcomes in microsurgery patients. Microsurgery 2022; 42:685-695. [PMID: 35838137 PMCID: PMC9349889 DOI: 10.1002/micr.30940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 05/25/2022] [Accepted: 07/01/2022] [Indexed: 11/11/2022]
Abstract
Background The healthcare industry's efforts to immunize the global community against severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) have been unprecedented. Given the fast‐tracking of the novel vaccine, its short‐ and long‐term medical implications remain largely to‐be‐determined in most patient populations. This study aims to analyze 90‐day post‐operative outcomes in microsurgical patients, who have received or not received SARS‐CoV‐2‐vaccination, using a continuously updated federated electronic medical record network (TriNetX Inc, Cambridge, MA). Methods After screening 70 million de‐identified records, 16,799 microsurgery patients aged 18–99 meeting medical coding criteria were allocated into two cohorts. Cohort One received SARS‐CoV‐2‐vaccination prior to undergoing microsurgery whereas Cohort Two did not. Two equally sized cohorts, totaling 818 patients were created after propensity score matching for characteristics including: age, race, ethnicity, smoking, hypertension, heart disease, diabetes, obesity, chronic obstructive pulmonary disease, and history of SARS‐CoV‐2 exposure. Postoperative outcomes within 30‐, 60‐, and 90‐days of microsurgery were analyzed. Results Patients who were SARS‐CoV‐2‐immunized experienced significantly lower (p < .01) surgical site infections (Absolute Risk Reduction (ARR)[95%CI]) = (3.79%–5.36% [0.84–8.54]) ICU admission (9.47%–9.82%[5.45–13.88]), generalized infections (7.68%–9.92%[3.15–14.64]), and hospitalizations (28.48%–32.57%[20.99–40.13]) within 30‐, 60‐, and 90‐days of microsurgery. Additionally, SARS‐CoV‐2‐vaccinated patients also experienced significantly less flap failure (2.49%[0.97–4.02]) and death (2.46%[0.96–3.97]) within 30‐ and 60‐days post‐operatively. Conclusion Our analysis examines the potential protective effect of SARS‐CoV‐2‐vaccination in microsurgical patients. Limitations include the retrospective nature of this analysis and the inherent reliance on medical coding. Future prospective studies are warranted to better understand if in fact pre‐operative SARS‐CoV‐2‐vaccination has the potential to protect against post‐operative microsurgery outcomes.
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Affiliation(s)
- Susan M Taghioff
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.,Anne Arundel Medical Center Luminis Health, Annapolis, Maryland, USA
| | - Benjamin R Slavin
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Manish Narasimman
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Georges Samaha
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mario Samaha
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Tripp Holton
- Anne Arundel Medical Center Luminis Health, Annapolis, Maryland, USA
| | - Devinder Singh
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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17
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Beutinger D, Caixeta-Umbelino C, Kasahara N. Visual field changes in glaucoma patients during the coronavirus disease 2019 pandemic in a middle-income country. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2096589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Daiane Beutinger
- Department of Ophthalmology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil
| | - Cristiano Caixeta-Umbelino
- Department of Ophthalmology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil
- Department of Ophthalmology, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
| | - Niro Kasahara
- Department of Ophthalmology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil
- Department of Ophthalmology, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
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18
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Na L. Characteristics of community-dwelling older individuals who delayed care during the COVID-19 pandemic. Arch Gerontol Geriatr 2022; 101:104710. [PMID: 35500472 PMCID: PMC9044630 DOI: 10.1016/j.archger.2022.104710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Ling Na
- School of Population Health, University of Toledo, Toledo, OH 43606, USA.
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19
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Rujkorakarn P, Patamatamkul S. Safety and Efficacy of Cataract Surgery Under a Local Infection Control Protocol Before and During a COVID-19 Wave in Thailand for Healthcare Workers and Patients: A Prospective Cohort from a Secondary Center. Clin Ophthalmol 2022; 16:1773-1781. [PMID: 35685377 PMCID: PMC9173727 DOI: 10.2147/opth.s366353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/25/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To assess the effectiveness of a local infection control protocol for cataract surgery (CS) during the coronavirus disease (COVID-19) pandemic and determine the trend of CSs and visual outcomes during this period, as compared to the pre-COVID-19 pandemic period. Methods This study was conducted at Suddhavej Hospital, Mahasarakham University, Mahasarakham, Thailand, between July 1, 2020, and March 31, 2021. In this two-phase study, we used only a COVID-19-screening questionnaire during the first phase and preoperative nasopharyngeal swab severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing for real-time reverse transcriptase-polymerase chain reaction in the second phase, during Thailand's second COVID-19 wave. Nasopharyngeal swab SARS-CoV-2 nucleic acid testing, SARS-CoV-2 IgG/IgM, or anti-SARS-CoV-2 spike antibody seroconversion was used to detect COVID-19 infection among healthcare workers. We also compared cataract surgical volume and postoperative visual acuity of CS patients between the pre-COVID-19 period and during the COVID-19 pandemic period. Results A total of 947 patients underwent CS. Thirty-two healthcare workers and 275 patients tested negative for SARS-CoV-2 in the second study phase. CSs increased on average by 50.09% month-to-month when the surgery was resumed. The mean postoperative logMAR best-corrected visual acuity was significantly better in the COVID-19 pandemic period than in the pre-pandemic period (difference, 0.1 [95% CI: 0.00-0.12], p < 0.0001). Conclusion CS could be safely performed under an infection control protocol during the COVID-19 pandemic. The cataract surgical volume, with favorable visual outcomes, has an increasing trend after resuming elective surgeries.
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Affiliation(s)
- Ploysai Rujkorakarn
- Department of Ophthalmology, Suddhavej Hospital, Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand
| | - Samadhi Patamatamkul
- Department of Internal Medicine, Suddhavej Hospital, Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand
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20
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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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21
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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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22
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Alagorie AR, Sorour OA, Eltoukhy H, Nassar E. Evaluation of Urgent Retinal Practice and Safety Measures for Physicians and Patients During COVID-19 Pandemic. Clin Ophthalmol 2022; 16:1197-1205. [PMID: 35480622 PMCID: PMC9037724 DOI: 10.2147/opth.s355628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the impact of the COVID-19 pandemic on urgent retina practice and factors influencing adherence of physicians and patients to safety measures. Methods In this clinical audit, urgent or emergent vitreoretinal surgical disorders that presented to our hospital during the period of 15th March-15th May 2020 were compared with the period just before the pandemic declaration (15th December 2019-15th February 2020). Additionally, two questionnaires assessing the adherence to safety measures were circulated to the medical personnel and a sample of patients. The collected data were analyzed, and accordingly, recommendations were proposed to the hospital administration and specific corrective measures were applied. The outcome of applying these corrective measures was assessed in the re-audit cycle during the period of 15th June-15th August 2020. Results There was a significant decrease in the number of urgent or emergent vitreoretinal surgical disorders that presented to our hospital during the pandemic (161 versus 302 cases in a similar period before the pandemic; p = 0.022). Just with the pandemic recession, there was a significant increase in the number of urgent cases (391 versus 161 cases during the pandemic; p = 0.006), also there was an increased number of complex cases. Residents and fellows were less compliant than attending physicians in adherence to safety measures. Conclusion Delayed presentation of urgent retinal cases during the pandemic highlights the importance of public awareness of urgent conditions that need immediate medical or surgical care. Attention to young physicians during the pandemic is crucial as they are less adherent to safety measures due to work overload.
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Affiliation(s)
| | - Osama A Sorour
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hesham Eltoukhy
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Elsayed Nassar
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
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23
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Glaucoma surgery during the first year of the COVID-19 pandemic. Int Ophthalmol 2022; 42:2881-2887. [PMID: 35430683 PMCID: PMC9013211 DOI: 10.1007/s10792-022-02278-6] [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: 05/11/2021] [Accepted: 03/12/2022] [Indexed: 11/25/2022]
Abstract
Purpose To summarize the actions taken to give continuity to the surgical treatment of glaucoma patients and to present the volume and characteristics of glaucoma surgery in the first year of pandemic at the Tertiary Glaucoma Center of the University Hospital of Verona (Veneto, Italy). Methods Demographical and surgical features of patients who underwent glaucoma surgery from March 9th, 2020 to March 8th, 2021 have been collected and compared to the same date range of the previous year. The analyzed data included age, gender, region of origin, glaucoma staging, type of anesthesia and surgical procedure. Results The surgical volume of glaucoma has dropped by 30.1%. In comparison with the previous year, we found a significant variation in the overall distribution of the performed surgical procedures (p < 0.001). There was a decline in Baerveldt tube implants (− 4.9%), and an increase of non-penetrating surgery (+ 2.6%), cyclo-photo ablative procedures (+ 4.2%) and MIGS (+ 5.7%). Only 24.3% of the procedures were performed under general anesthesia compared to 41.5% in the pre-pandemic period (p < 0.001). The number of procedures performed on eyes affected by advanced or end-stage glaucoma is doubled (p < 0.001). Conclusions To give continuity to glaucoma surgery, we prioritized interventions on patients with poorer visual fields, rapidly progressing visual field deficit and elevated IOP uncontrolled by maximal medical therapy. Secondly, we have rescheduled the other interventions following the same priority criteria. Finally, we managed some lower priority cases with MIGS, minimizing the need for close post-intervention follow-up. Considering the negative consequences that a delay in the management of glaucoma can have in terms of visual loss, the closure of the operating rooms in the first quarter of the pandemic was detrimental. It appears that glaucoma surgery deserves urgencies that cannot be overshadowed and the greatest effort must be to give continuity to this type of eye surgery. Supplementary Information The online version contains supplementary material available at 10.1007/s10792-022-02278-6.
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24
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Momenaei B, Cheraqpour K, Soleimani M, Tabatabaei SA, Shahriari M, Etesali H, Hussein A, Vaseghi Y, Ramezani B, Djalilian AR. Ophthalmic side effects of COVID-19 vaccines. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2066523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bita Momenaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Seyed Ali Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoor Shahriari
- Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Etesali
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmed Hussein
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Vaseghi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Ramezani
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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25
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Belda JI, Placeres J, Elvira JC, Puig X, Pérez-Vives C, Zou M, Sun S, Yu J, O’Boyle D. Costs and Healthcare Resource Utilization Associated with Posterior Capsule Opacification After Cataract Surgery with Five Different Intraocular Lenses: An Economic Analysis for Spain. Clin Ophthalmol 2022; 16:993-1001. [PMID: 35386615 PMCID: PMC8979752 DOI: 10.2147/opth.s349003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- José I Belda
- Hospital Universitario de Torrevieja, Torrevieja, Alicante, Spain
| | - Javier Placeres
- Hospital Universitario de Torrevieja, Torrevieja, Alicante, Spain
| | | | | | | | - Ming Zou
- IQVIA Real World Solutions, Basel, Switzerland
| | - Shaohui Sun
- IQVIA Real World Solutions, Basel, Switzerland
| | - Jing Yu
- IQVIA Real World Solutions, Basel, Switzerland
| | - Derek O’Boyle
- Alcon Laboratories Ireland Ltd., Cork, Ireland
- Correspondence: Derek O’Boyle, Alcon Laboratories Ireland Ltd., Cork, Ireland, Email
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26
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Vest A, Keilani C, Chaumet-Riffaud P, Barale PO, Tuil E, Ayello-Scheer S, Koch E, Abada S, Giocanti-Auregan A, Durand-Zaleski I, Delbarre M, Froussart-Maille F, Beaugrand A, Tadayoni R, Sahel JA, Paques M. Incidence and characteristics of rhegmatogenous retinal detachment during coronavirus-19 pandemic: A French study. Eur J Ophthalmol 2022; 32:3644-3649. [PMID: 35172628 PMCID: PMC8859482 DOI: 10.1177/11206721221080810] [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] [Indexed: 11/20/2022]
Abstract
Purpose To assess the impact of the Covid-19 pandemic and subsequent lockdown on the number and clinical characteristics of patients with retinal detachment (RD) in a French public university eye hospital. Methods Single-center, retrospective non-interventional study. Patients consulting at the emergency room (ER) of Quinze-Vingts Hospital (France) for rhegmatogenous RD before and after instauration of the lockdown were reviewed. We compared the characteristics of patients with RD between the containment period (March17th - April27th,2020) and the period preceding the lockdown (February18th - March16th,2020). We compared the number of RD surgeries performed between the first month of lockdown (March17th - April19th,2020) and the corresponding period of 2019. Number of cases, delay between diagnosis and surgery, visual acuity was measured. Results During the first month of lockdown, 59 RDs were operated on, compared to 107 in the corresponding period in 2019 (-44,8%). Mean time from first symptoms to surgery was significantly higher during the lockdown 12.7 (11.3) days vs 7.6 (7.8) days (p = 0.031) before. During the lockdown, the mean BCVA was lower albeit the difference did not reach statistical significance (1.16 (0.9) during pre-containment vs 1.5 (0.9) during containment; p = 0.09). Reasonsfor delayed consultation were: fear of Covid-19 (31%; p = 0.0001), absence of referral doctor (31%; p = 0.003) and difficulties in getting to public transport (10.3%;p = 0.859). Conclusion Despite maintaining accessto emergency eye care facilitiesin our hospital, the lockdown affected visual health. Should the lockdown be reinstated, we postulate that a better information about eye care access for non-Covid emergencies may attenuate its effect on visual health.
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Affiliation(s)
- Agathe Vest
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France.,Faculty of Medicine Hyacinthe Bastaraud, University of the French West Indies and French Guiana, Pointe-à-Pitre, France
| | - Chafik Keilani
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France.,Department of ophthalmology, Percy Military Hospital, Clamart, France.,Pôle ophtalmologique Clemenceau, Rennes, France.,Cabinet d'ophtalmologie La Visitation, Rennes, France
| | - Philippe Chaumet-Riffaud
- Service de Biophysique et Médecine Nucléaire, Hôpital de Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | | | - Eric Tuil
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France
| | - Sarah Ayello-Scheer
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France
| | - Edouard Koch
- Department of ophthalmology, Versailles Hospital (André Mignot), Le Chesnay, France
| | - Samir Abada
- Department of ophthalmology, 37107François-Quesnay Hospital, Mantes-la-Jolie, France
| | | | | | - Maxime Delbarre
- Department of ophthalmology, Percy Military Hospital, Clamart, France
| | | | - Amélie Beaugrand
- Department of Biomedical Informatics, 55862Quinze-Vingts National Hospital, Paris, France
| | - Ramin Tadayoni
- Department of ophthalmology, Paris University, Lariboisière Hospital, F-75010, Paris, France.,Department of ophthalmology, Rothschild Foundation, Paris, France
| | - José-Alain Sahel
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France.,INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France
| | - Michel Paques
- Department of Ophthalmology IV, 55862Quinze-Vingts National HospitalParis, France.,INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France
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27
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Scarpa G, Urban F, Scarpa M, Formentini S, Beccastrini A. Intravitreal Injections during the COVID-19 Outbreak in Northern Italy: An Innovative Approach for a High Quality and Safe Treatment. Eur J Ophthalmol 2022; 32:3667-3673. [PMID: 35132906 DOI: 10.1177/11206721221078554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Intravitreal injection (IVI) is a standard procedure performed in ophthalmology to treat several conditions, and is performed in different settings across countries. The Italian guidelines recommend this intervention is performed in an operating room to minimize the risk of infections, while in other countries, including Canada, USA and the UK, IVIs are performed in the ophthalmologist's office. The 2020 COVID-19 outbreak caused a dramatic modification in outpatient care. Consequently, non-urgent surgical activities, like IVIs, were subjected to a drastic reduction. METHODS We conducted observational study which investigated the outcomes of IVIs performed in an ophthalmologist's office using a mobile laminar flow unit, the Operio mobile (Toul Meditech, Operio®) versus an operating room setting. RESULTS Use of the Operio mobile allowed the safety performance of 3838 IVIs during COVID-19 and significantly reduced the waiting time of the first visit. This results in a faster intervention without affecting the technical IVI procedure that remained unchanged comparing the two settings. Specifically, we observed a 26% reduction in operation costs for each IVI performed in the office, which can be translated to a higher impact when considering the total number of IVIs performed over one year. CONCLUSION The use of the Operio mobile in an ophthalmologist's office provides flexibility to perform IVIs, assuring patient safety, reducing healthcare personnel employment times, and the waiting lists for the patients, increasing the number of surgeries and improving the cost-effectiveness of the procedure.
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Affiliation(s)
- Giuseppe Scarpa
- 18173Azienda ULSS n 2 Marca Trevigiana, Treviso, Veneto, Italy
| | - Francesca Urban
- 18173Azienda ULSS n 2 Marca Trevigiana, Treviso, Veneto, Italy
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28
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Leung KFC, Golzan M, Egodage C, Rodda S, Cracknell R, Macken P, Kaushik S. Impact of COVID-19 pandemic on ophthalmic presentations to an Australian outer metropolitan and rural emergency department: a retrospective comparative study. BMC Ophthalmol 2022; 22:40. [PMID: 35090415 PMCID: PMC8796873 DOI: 10.1186/s12886-022-02271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To analyse ophthalmic presentations to an outer metropolitan and a rural emergency department (ED) during the first wave of the COVID-19 pandemic in New South Wales (NSW), Australia.
Methods
A retrospective comparative study of ophthalmic emergency presentations to Campbelltown Hospital (fifth busiest NSW metropolitan ED; population 310,000) and Bowral and District Hospital (rural ED; population 48,000) before and during COVID-19 was conducted. Patient demographics, triage category, referral source, diagnosis, length of stay, departure status, and follow-up location were assessed from coding data between March 1st to May 31st in 2019 and 2020, corresponding to the peak case numbers and restrictions during the first wave of the COVID-19 pandemic in NSW. Differences before and during COVID-19 were analysed using chi-squared tests or independent sample t-tests.
Results
There was no change in ophthalmic presentations at Campbelltown (n = 228 in 2019 vs. n = 232 in 2020; + 1.75%, p = 0.12) and an increase at Bowral (n = 100 in 2019 vs. n = 111 in 2020; + 11%, p < 0.01) during COVID-19. Urgent ophthalmic presentations (Triage Category 3) decreased at Bowral (p = 0.0075), while non-urgent ophthalmic presentations (Triage Category 5) increased at both hospitals (Campbelltown p < 0.05, Bowral p < 0.01).
Conclusions
There was no change in the total number of ophthalmic presentations to an outer metropolitan and an increase to a rural ED during the first wave of the COVID-19 pandemic in New South Wales, Australia. A change in the type of ophthalmic presentations at these peripheral EDs suggest that a high demand for ophthalmic services remained despite the pandemic and its associated gathering and movement restrictions. A flexible healthcare delivery strategy, such as tele-ophthalmology, may optimise patient care during and after COVID-19.
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29
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Ferreira Caceres MM, Sosa JP, Lawrence JA, Sestacovschi C, Tidd-Johnson A, Rasool MHUI, Gadamidi VK, Ozair S, Pandav K, Cuevas-Lou C, Parrish M, Rodriguez I, Fernandez JP. The impact of misinformation on the COVID-19 pandemic. AIMS Public Health 2022; 9:262-277. [PMID: 35634019 PMCID: PMC9114791 DOI: 10.3934/publichealth.2022018] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 11/25/2022] Open
Abstract
Since the inception of the current pandemic, COVID-19 related misinformation has played a role in defaulting control of the situation. It has become evident that the internet, social media, and other communication outlets with readily available data have contributed to the dissemination and availability of misleading information. It has perpetuated beliefs that led to vaccine avoidance, mask refusal, and utilization of medications with insignificant scientific data, ultimately contributing to increased morbidity. Undoubtedly, misinformation has become a challenge and a burden to individual health, public health, and governments globally. Our review article aims at providing an overview and summary regarding the role of media, other information outlets, and their impact on the pandemic. The goal of this article is to increase awareness of the negative impact of misinformation on the pandemic. In addition, we discuss a few recommendations that could aid in decreasing this burden, as preventing the conception and dissemination of misinformation is essential.
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Affiliation(s)
| | - Juan Pablo Sosa
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
| | - Jannel A Lawrence
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
| | - Cristina Sestacovschi
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
| | - Atiyah Tidd-Johnson
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
- Department of Medicine, American University of Antigua, Coolidge, Antigua
| | | | - Vinay Kumar Gadamidi
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
| | - Saleha Ozair
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
| | - Krunal Pandav
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
| | - Claudia Cuevas-Lou
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Hialeah, Florida, USA
| | - Matthew Parrish
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Hialeah, Florida, USA
| | - Ivan Rodriguez
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
- Family Medicine, Larkin Community Hospital South Campus, Miami, Florida, USA
| | - Javier Perez Fernandez
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, Florida, USA
- Pulmonary Disease and Critical Care Medicine, Larkin Community Hospital Palm Springs Campus, Hilaeah, Florida, USA
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30
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Hanhart J, Wiener R, Totah H, Gelman E, Weill Y, Abulafia A, Zadok D. Effects of delay in anti-vascular endothelial growth factor intravitreal injections for neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2022; 260:1907-1914. [PMID: 35013800 PMCID: PMC8747863 DOI: 10.1007/s00417-021-05505-5] [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: 06/17/2021] [Revised: 10/24/2021] [Accepted: 11/18/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose To assess the impact of COVID-19-related delay in intravitreal injection timing on macular structure and visual acuity (VA) among patients treated for neovascular age-related macular degeneration (nvAMD). Methods We reviewed demographic and clinical data and macular ocular computerized tomographic images of 34 patients (48 eyes, group A) who did not follow their injection schedule during the first wave of COVID-19 and compared them to 46 patients (71 eyes, group B) who did. Functional worsening was defined as a loss of at least 0.1 in decimal VA. Anatomic worsening was defined as new or increased subretinal/intraretinal fluids or new hemorrhage. Results The planned mean ± standard deviation intervals between the intravitreal injections were 5.7 ± 2.7 weeks for group A and 5.5 ± 2.4 weeks for group B (P = 0.60). The actual intervals were 13.6 ± 6.8 (7.9 ± 5.2 weeks’ delay) and 5.3 ± 2.4 weeks (no delay), respectively (P < 0.001). The best corrected visual acuity worsened in 23 group A eyes (47.9%) and in 6 group B eyes (8.5%) (odds ratio [OR] 9.97, P < 0.001). Anatomic features indicative of nvAMD worsening were detected in 31 group A eyes (64.6%) and in 16 group B eyes (22.5%) (OR 5.73, P < 0.001). A new macular hemorrhage was observed in 4 group A eyes (8.3%) and in no group B eyes (P = 0.09). Conclusion Delay in timely retinal care during the COVID-19 restrictions period resulted in short-term negative outcomes, including macular bleeding, in nvAMD patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05505-5.
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Affiliation(s)
- Joel Hanhart
- Department of Ophthalmology, Shaare Zedek Medical Center, Affiliated to the Hebrew University, 12 Shmuel Bait St., 9103102, Jerusalem, Israel.
| | - Rony Wiener
- Department of Ophthalmology, Shaare Zedek Medical Center, Affiliated to the Hebrew University, 12 Shmuel Bait St., 9103102, Jerusalem, Israel
| | - Hashem Totah
- Department of Ophthalmology, Shaare Zedek Medical Center, Affiliated to the Hebrew University, 12 Shmuel Bait St., 9103102, Jerusalem, Israel
| | - Evgeny Gelman
- Department of Ophthalmology, Shaare Zedek Medical Center, Affiliated to the Hebrew University, 12 Shmuel Bait St., 9103102, Jerusalem, Israel
| | - Yishay Weill
- Department of Ophthalmology, Shaare Zedek Medical Center, Affiliated to the Hebrew University, 12 Shmuel Bait St., 9103102, Jerusalem, Israel
| | - Adi Abulafia
- Department of Ophthalmology, Shaare Zedek Medical Center, Affiliated to the Hebrew University, 12 Shmuel Bait St., 9103102, Jerusalem, Israel
| | - David Zadok
- Department of Ophthalmology, Shaare Zedek Medical Center, Affiliated to the Hebrew University, 12 Shmuel Bait St., 9103102, Jerusalem, Israel
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31
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Testing the eligibility of glaucoma patients for potential gene therapy among a clinic population. Int Ophthalmol 2022; 42:785-797. [PMID: 34989952 DOI: 10.1007/s10792-021-02044-0] [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: 03/19/2021] [Accepted: 09/22/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Glaucoma patients who deteriorate despite standard treatment may benefit from novel gene therapies. Key inclusion criteria for a glaucoma gene therapy trial were devised. A retrospective chart review in a glaucoma clinic population was conducted. Feasibility of gene therapy inclusion criteria and factors associated with progression and fast progression < -1 decibels/year (dB/y) were evaluated. METHODS Three hundred and seventy-four primary open-angle glaucoma patients all of whom had performed at least five Swedish interactive threshold algorithm standard visual fields within a 58-month period. Two definitions were applied to characterize visual field progression rate using Guided Progression Analysis for an individual patient based on A, the eye with the greatest visual field loss, or B, the eye with the most rapid progression rate. RESULTS Mean rate of visual field progression was -0.50 dB/y (Definition A) and -0.64 dB/y (Definition B). 19.0% (A) and 21.9% (B) of eyes, 71 (A) and 82 (B) eyes, were 'fast progressors' (< -1 dB/y). 37 (A) and 43 (B) eyes met the putative gene therapy inclusion criteria (≥ 50 years; mean deviation ≤ -4 to ≥ -12 or ≤ -20 dB, progression rate between -1 and -4 dB/y). Beta blockers (Odds ratio (OR) with 95% Confidence Intervals (CI): 2.84 (1.39-5.80); p = 0.004) (A), (OR (95%CI): 2.48 (1.30-4.75); p = 0.006) (B) and alpha agonists (OR (95%CI): 2.18 (1.14-4.17); p = 0.02) (A), (OR (95%CI) 2.00 (1.08-3.73); p = 0.028) (B) were significantly associated with fast progression. CONCLUSION A substantial proportion (10%) of patients in this clinic population would meet recommended gene therapy inclusion criteria.
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32
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Cutolo CA, Bonzano C, Scotto R, Iester M, Bagnis A, Pizzorno C, Catti C, Traverso CE. Moving beyond the Slit-Lamp Gonioscopy: Challenges and Future Opportunities. Diagnostics (Basel) 2021; 11:2279. [PMID: 34943516 PMCID: PMC8700682 DOI: 10.3390/diagnostics11122279] [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] [Received: 10/25/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 12/01/2022] Open
Abstract
After almost a century from its introduction in clinical practice, slit-lamp gonioscopy is still considered the reference standard for evaluating the anterior chamber angle (ACA). Gonioscopy is essential for diagnosing angle closure disease, and ACA features are included in glaucoma's diagnostics and treatments algorithms. However, shortcomings of slit-lamp gonioscopy include a steep learning curve, lack of agreement between examiners and poor documentation. Thanks to advances in miniaturization and computing, new instruments for digital gonioscopy have been developed and marketed. This narrative review focuses on the Gonioscope GS-1, which permits semi-automated circumferential documentation of the ACA in real-colour photographs. Advantages and disadvantages of GS-1 compared with slit-lamp gonioscopy and other ACA imaging technologies such as optical coherence tomography are discussed. Finally, potential opportunities offered by this device for telemedicine, virtual clinics, and automatic classification with deep learning are presented.
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Affiliation(s)
- Carlo Alberto Cutolo
- Clinica Oculistica, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.B.); (R.S.); (M.I.); (A.B.); (C.P.); (C.C.); (C.E.T.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Chiara Bonzano
- Clinica Oculistica, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.B.); (R.S.); (M.I.); (A.B.); (C.P.); (C.C.); (C.E.T.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Riccardo Scotto
- Clinica Oculistica, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.B.); (R.S.); (M.I.); (A.B.); (C.P.); (C.C.); (C.E.T.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Michele Iester
- Clinica Oculistica, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.B.); (R.S.); (M.I.); (A.B.); (C.P.); (C.C.); (C.E.T.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Alessandro Bagnis
- Clinica Oculistica, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.B.); (R.S.); (M.I.); (A.B.); (C.P.); (C.C.); (C.E.T.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Chiara Pizzorno
- Clinica Oculistica, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.B.); (R.S.); (M.I.); (A.B.); (C.P.); (C.C.); (C.E.T.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Carlo Catti
- Clinica Oculistica, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.B.); (R.S.); (M.I.); (A.B.); (C.P.); (C.C.); (C.E.T.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Carlo Enrico Traverso
- Clinica Oculistica, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (C.B.); (R.S.); (M.I.); (A.B.); (C.P.); (C.C.); (C.E.T.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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Almaliotis D, Athanasopoulos GP, Almpanidou S, Papadopoulou EP, Karampatakis V. The contribution of wet labs in the education of ophthalmologists. Ann Med Surg (Lond) 2021; 72:103034. [PMID: 34824838 PMCID: PMC8604746 DOI: 10.1016/j.amsu.2021.103034] [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: 09/07/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background The need for pre-training in experimental eye surgery is considered necessary. It is an essential way to assess trainees in ophthalmology based on their instrument and tissue handling and skills. This article aims to underline this necessity and demonstrate the ocular health professionals' opinion on this issue. Methods 74 participants (45 females and 29 males) were included in the study. Ophthalmology residents, ophthalmologists participated in the wet lab session. The evaluation of the contribution of the wet labs were provided by filling a new questionnaire form. In this way, an interactive questionnaire was developed. Results Regarding trainees' grading of wet labs' significance as a first step for guiding their surgical career, it was positively correlated with their subjective view of labs' utility to both improve their surgical skills (p = 0.001) and maintain pre-existing ones (p < 0.001). We should also note that all of them (100%) stated that wet labs were necessary during residency, especially in repeated sessions, and that they would recommend them to their colleagues. Conclusion The surgical skills improved significantly after participation in a wet lab, according to participants, who rated the experience as highly educational. Wet labs can reduce the learning curve of difficult surgical techniques, accelerate the rate for trainees to achieve surgical competency, and treat patients safely and effectively. Pre-training in experimental eye surgery is considered to be necessary. Health professionals evaluated the role of wet labs by filling a new questionnaire. Participants had a positive opinion on wet labs' role, especially during residency. Wet labs can reduce the learning curve of difficult surgical techniques. Safe and effective treatment of ophthalmology patients is more feasible.
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Affiliation(s)
- Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios P Athanasopoulos
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Stavroula Almpanidou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Eleni P Papadopoulou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Vasileios Karampatakis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Greece
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Puzo M, Sánchez-Monroy J, Porcar-Plana CA, Bartol-Puyal FDA, Dotti-Boada M, Peña-Urbina P, Izquierdo-Serra J, López-Montero A, Pérez-García P, Bordonaba-Bosque D, Pablo LE, Calvo P. Ocular related emergencies in Spain during the COVID-19 pandemic, a multicenter study. BMC Ophthalmol 2021; 21:408. [PMID: 34837985 PMCID: PMC8626758 DOI: 10.1186/s12886-021-02169-x] [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: 03/17/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate ophthalmological emergencies (OE) during the COVID-19 pandemic comparing them with the same period of the previous year. METHODS Retrospective observational study of all OE visits in four tertiary hospitals in Spain comparing data from March 16th to April 30th, 2020 (COVID-19 period) and the same period of 2019 (pre-COVID-19 period). Severity of the conditions was assessed following Channa et al. publication. Data on demographics, diagnosis and treatments were collected from Electronic Medical Records. RESULTS During lockdown, OE significantly declined by 75.18%, from 7,730 registered in the pre-COVID-19 period to 1,928 attended during the COVID-19 period (p < 0.001). In 2019, 23.86% of visits were classified as emergent, 59.50% as non-emergent, and 16.65% could not be determined. In 2020, the percentage of emergent visits increased up to 29.77%, non-emergent visits significantly decreased to 52.92% (p < 0.001), and 17.31% of the visits were classified as "could not determine". During the pandemic, people aged between 45 and 65 years old represented the largest attending group (37.89%), compared to 2019, where patients over 65 years were the majority (39.80%). In 2019, most frequent diagnosis was unspecified acute conjunctivitis (11.59%), followed by vitreous degeneration (6.47%), and punctate keratitis (5.86%). During the COVID-19 period, vitreous degeneration was the first cause for consultation (9.28%), followed by unspecified acute conjunctivitis (5.63%) and punctate keratitis (5.85%). CONCLUSIONS OE visits dropped significantly during the pandemic in Spain (75.18%), although more than half were classified as non-urgent conditions, indicating a lack of understanding of the really emergent ocular pathologies among population.
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Affiliation(s)
- Martín Puzo
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain. .,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain.
| | - Jorge Sánchez-Monroy
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain
| | | | - Francisco de Asís Bartol-Puyal
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | | | - Pilar Peña-Urbina
- Ophthalmology Department, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Ana López-Montero
- Ophthalmology Department, Hospital Clínico Universitario, Valencia, Spain
| | | | | | - Luis E Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - Pilar Calvo
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain
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González-Martín-Moro J, Guzmán-Almagro E, Izquierdo Rodríguez C, Fernández Hortelano A, Lozano Escobar I, Gómez Sanz F, Contreras I. Impact of the COVID-19 Lockdown on Ophthalmological Assistance in the Emergency Department at a Spanish Primary Level Hospital. J Ophthalmol 2021; 2021:8023361. [PMID: 34840824 PMCID: PMC8616649 DOI: 10.1155/2021/8023361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To analyze the changes in ophthalmological emergencies during the COVID-19 pandemic lockdown at a Spanish primary level hospital. METHODS The number and type of emergencies attended in the emergency department of Hospital Universitario del Henares between March 10 and August 31, 2020 (COVID-19 cohort) were compared with the emergencies attended during the same period of 2019 (pre-COVID-19 cohort). Data on the diagnosis, patient age, and gender was retrospectively collected from the electronic medical records of the hospital. The different diagnoses were organized into "clusters," which include those conditions that affect the same ocular tissue and that have similar clinical expression. RESULTS The number of ophthalmological emergencies during the study period was 841, compared to 1343 during the same month of 2019, which represents a reduction of 37.4%. The percentage reduction in each cluster was as follows: conjunctiva (-65.4%), cornea (-35.8%), uveitis (-3.6%), eyelid and orbital and lacrimal (-35.5%), strabismus (-60%), neuro-ophthalmology (-11.8%), retina (-10.6%), cataract (+16.4%), glaucoma (-37%), and miscellaneous (-45.1%). The number of people seen with viral conjunctivitis decreased by -87.1% compared to 2019. Patients with complications due to conjunctivitis also decreased: patients with pseudomembranes dropped from 16 to 4 cases and patients with corneal subepithelial infiltrates from 9 to 3 cases. CONCLUSIONS Most diagnostic clusters showed a similar decrease. Clusters that included vision-threating conditions (retina, neuro-ophthalmology, and uveitis) remained mostly stable. During the COVID-19 lockdown, the diagnosis of adenoviral conjunctivitis decreased nearly 10 times. This fact may represent a decrease in the transmission of these infections.
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Affiliation(s)
- Julio González-Martín-Moro
- Department of Ophthalmology, Hospital Universitario del Henares, Madrid, Spain
- Department of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | | | | | | | - Fernando Gómez Sanz
- Department of Ophthalmology, Hospital Universitario del Henares, Madrid, Spain
- Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Inés Contreras
- Department of Ophthalmology, University Hospital Ramón y Cajal, Madrid, Spain
- Clínica Rementería, Madrid, Spain
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Toro MD, Bremond-Gignac D, Brézin AP, Cummings AB, Kemer OE, Kermani O, Malyugin BE, Prieto I, Teus MA, Tognetto D, Zweifel S, Rejdak R. COVID-19 outbreak and increased risk of amblyopia and epidemic myopia: Insights from EUROCOVCAT group. Eur J Ophthalmol 2021; 32:17-22. [PMID: 34751045 DOI: 10.1177/11206721211053175] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The most common cause of vision impairment in children is amblyopia. It is defined as impaired visual acuity in one or both eyes that is present with no demonstrable abnormality of the visual pathway and is not immediately resolved by wearing glasses. After the World Health Organization (WHO) recognized COVID-19 as a global pandemic on March 11, 2020, widespread changes and restrictions to social and sanitary practices have presented significant issues in access to eye care during the COVID-19 pandemic. A reduction of more than 80% in pediatric eye care volume up to its total cessation has been observed in different departments. In this scenario, reduced or absent eyesight, due to delay in timely treatment of amblyopic conditions, could create major, long-lasting effects on all aspects of life, including daily personal activities, interacting with the community, school and work opportunities and the ability to access public services. Processes coming out of lockdown should be gradually easing restrictions giving priority to ophthalmology and eye care facilities so that amblyopia does not remain unattended and irreversible as in adults due to lack of timely treatments. If not reversible, this process could lead to a dramatic increase in disability and unsustainable social costs for many governments.
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Affiliation(s)
- Mario Damiano Toro
- Department of General and Pediatric Ophthalmology, 49554Medical University of Lublin, Lublin, Poland.,Department of Ophthalmology, University Hospital of Zurich, Zurich, Switzerland
| | - Dominique Bremond-Gignac
- 246596University Hospital Necker Enfants Malades, APHP, Paris, France.,INSERM 1138, Team 17, Paris Sorbonne University, Cordeliers, Paris, France
| | | | | | | | - Omid Kermani
- Augenklinik am Neumarkt Schildergasse 107 - 109, Köln, Germany
| | - Boris Edvard Malyugin
- 96710Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation.,A. Yevdokimov Moscow State University of Medicine and Dentistry, Russian Federation
| | | | | | | | - Sandrine Zweifel
- Department of Ophthalmology, University Hospital of Zurich, Zurich, Switzerland
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, 49554Medical University of Lublin, Lublin, Poland
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Franzolin E, Longo R, Gusson E, Ficial B, Marchini G. Pediatric eye emergency department activity during the first wave of Covid-19 pandemic. Ital J Pediatr 2021; 47:217. [PMID: 34736495 PMCID: PMC8567118 DOI: 10.1186/s13052-021-01167-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background We investigated the volume and the characteristics of pediatric eye emergency department (PEED) consultations performed at our tertiary eye center during the early months of the COVID-19 pandemic and we compared them to those carried out in the same time interval of the previous three years. Methods Ophthalmic emergency examinations of patients aged ≤18 years old and done during the national COVID-19 lockdown (March 9th, 2020 – May 3rd, 2020) and in the corresponding date range of the previous three years (2017, 2018, and 2019) have been considered and reviewed. The following features were retrieved and analyzed: age, gender, duration and type of accused symptoms, traumatic etiology, and the discharge diagnosis. Results 136, 133, and 154 PEED visits have been performed respectively in 2017, 2018, and 2019, while 29 patients presented in 2020. Therefore, the volume of PEED activity decreased by 79.4% (p < 0.0001). Demographical and clinical characteristics were comparable to those of the pre-COVID period. Despite the absolute reduction in the number of traumas, urgent conditions increased significantly from 30.7 to 50.7% (p = 0.024). Conclusions PEED activity decreased consistently after the onset of the pandemic and it was mainly attended by those children whose conditions required prompt assistance, reducing the number of patients diagnosed with milder pathologies. At the end of the emergency, better use of PEED could avoid overcrowding and minimize waste, allowing resource optimization for the management of urgent cases.
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Affiliation(s)
- Elia Franzolin
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Rosa Longo
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elena Gusson
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Benjamim Ficial
- Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Verona, Verona, Italy.
| | - Giorgio Marchini
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Can a Set of Questions after Routine Cataract Surgery Predict Unexpected Findings and Avoid an Unnecessary Follow-Up Visit? Medicina (B Aires) 2021; 57:medicina57111144. [PMID: 34833362 PMCID: PMC8620108 DOI: 10.3390/medicina57111144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/12/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: to evaluate whether a set of questions after a routine cataract surgery can predict unexpected findings and avoid an unnecessary follow-up visit. Materials and Methods: single-center, prospective, cohort study included 177 routine cataract surgery cases of two experienced surgeons between November 2019 and December 2020. Inclusion criteria included unremarkable postoperative day one follow-up examination. A set of seven questions regarding complaints with positive or negative answers was presented at the second follow-up visit (PV2)—one week (mean 8.34 ± 1.73 days) after the surgery. The outcome measures were the incidence of unexpected management changes (UMCs) at the PV2 visit (change or addition from a prescribed postoperative drop plan, extra procedures, an urgent referral to an ophthalmologist) and UMCs associations with the answers to a question set. Results: 81.4% of patients had no complaints about postoperative ocular status and answered with negative answers, 18.6% reported one or more complaint (positive answer): dissatisfaction with postoperative visual acuity (6.2%, 11 cases), eye pain (4.0%, 7 cases), increase in floaters after the surgery (4.0%, 7 cases), red eye (4.0%, 7 cases) and others. The prevalence of UMCs at PV2 was 1.7% (3 cases), of which 0.6% (1 case) was the prolonged antibiotic prescription due to conjunctivitis, 0.6% (1 case) was the addition of IOP lowering medication and 0.6% (1 case) was additional medication due to uveitis management. None of the complaints (positive answers) at PV2 were associated with the incidence of UMCs (p > 0.05). Conclusions: there were no associations of UMCs determined with positive answers to the questions. The prediction of UMCs incidence based on the positive answers was not obtained. Thus, we cannot exclude the necessity of a postoperative week one follow-up visit.
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Li J, Zhao M, She H. The impact of the COVID-19 Pandemic on rhegmatogenous retinal detachment treatment patterns. BMC Ophthalmol 2021; 21:372. [PMID: 34666710 PMCID: PMC8524212 DOI: 10.1186/s12886-021-02127-7] [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: 07/01/2021] [Accepted: 09/23/2021] [Indexed: 02/02/2023] Open
Abstract
Backgrounds To describe changes in rhegmatogenous retinal detachment (RRD) surgical procedures in Beijing during the COVID-19 Pandemic. Methods A retrospective cohort of RRD patients was analyzed. Patients were divided into the COVID-19 pandemic group and pre-COVID-19 group according to their presentation. The presurgery characteristics, surgical procedures, and surgery outcomes were collected. The potential factors related to the choice of pars plana vitrectomy (PPV) or scleral buckling (SB) were analyzed using logistic regression. The differences in the procedure choice under specific conditions were compared. Surgery outcomes were compared between the two groups. Results In the COVID-19 pandemic group, less patients received SB (27.8, 41.3%, p = 0.02) while more patients received PPV (72.2, 58.6%, p = 0.02); in patients who received SB, fewer patients received subretinal fluid drainage (45.4,75.7%, p = 0.01); in patients who received PPV, fewer patients received phacovitrectomy (7.0, 21.0%, p = 0.02). The choice of PPV was related to older age (1.03, p = 0.005), the presence of RRD with choroidal detachment (RRD-CD) (2.92, p = 0.03), pseudophakia (5.0, p = 0.002), retinal breaks located posterior to the equator (4.87, p < 0.001), macular holes (9.76, p = 0.005), and a presurgery visual acuity (VA) less than 0.02 (0.44, p = 0.03). Fewer phakia patients with retinal breaks located posterior to the equator (1/28, 11/30, p = 0.01) and fewer patients with chronic RRD and subretinal strand (1/9, 9/16, p = 0.03) received SB in the COVID-19 pandemic group. There were more patients with improved VA (55.7, 40.2%, p = 0.03) in the COVID-19 pandemic group. The overall single-surgery retinal attachment rate was similar in the two groups (94.9, 94.5%, p = 0.99). Conclusions During the COVID-19 Pandemic, the main reason for the increased number of PPV in RRD treatment was that more complicated cases were presented. However, the surgeons were conservative in procedure choice in specific cases. The adjustments on RRD treatments lead to comparable surgery outcomes.
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Affiliation(s)
- Jipeng Li
- Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, No1. Dongjiaominxiang street, Dongcheng District, Beijing, 100730, China
| | - Meng Zhao
- Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, No1. Dongjiaominxiang street, Dongcheng District, Beijing, 100730, China.
| | - Haicheng She
- Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, No1. Dongjiaominxiang street, Dongcheng District, Beijing, 100730, China
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Lee Y, Park WK, Kim RY, Kim M, Park YG, Park YH. Characteristics of retinal detachment associated with atopic dermatitis. BMC Ophthalmol 2021; 21:359. [PMID: 34635058 PMCID: PMC8504004 DOI: 10.1186/s12886-021-02135-7] [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: 11/13/2020] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the characteristics of rhegmatous retinal detachment (RRD) associated with atopic dermatitis. METHOD Medical records of 2257 patients who underwent RD surgery at this clinic between 2008 and 2018 were retrospectively reviewed. Among them, 61 patients who were diagnosed as AD were assigned into the experimental group and 100 patients who did not have AD were randomly selected and assigned into the control group. Demographics, characteristics of detachment, initial operative method, and prognosis after surgery were investigated as main outcomes. Additionally, in pseudophakic RD patients, the period between the cataract surgery and onset of RD was measured. RESULT Postoperative VA and prognosis were significantly worse and bilateral involvement of RD was more common in the atopy group than in the control group. (P value = 0.005, 0.001 each) Characteristics of retinal breaks were different between the two groups. Additionally, the risk of developing RD within 1 year after cataract surgery was significantly higher in pseudophakic patients of the atopic group than in the control group. (P value = 0.013) However, there was no significant difference in mean preoperative VA or refractive index between the two groups. CONCLUSION Our results show that in atopic patients, RD occurs at a young age with different characteristics compared to non-atopic patients. Atopic RD has a poor visual prognosis. Thus, it requires careful management. Furthermore, the risk of developing RD within 1 year after cataract surgery is higher in atopic patients. Therefore, it is important to perform regular and extensive check-up after cataract surgery for atopic patients.
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Affiliation(s)
- Youlim Lee
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woo Kyung Park
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Rae-Young Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mirinae Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Gun Park
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Hoon Park
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea. .,Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea. .,Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea.
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Tognetto D, Giglio R, Vinciguerra AL, Milan S, Rejdak R, Rejdak M, Zaluska-Ogryzek K, Zweifel S, Toro MD. Artificial intelligence applications and cataract management: A systematic review. Surv Ophthalmol 2021; 67:817-829. [PMID: 34606818 DOI: 10.1016/j.survophthal.2021.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/26/2022]
Abstract
Artificial intelligence (AI)-based applications exhibit the potential to improve the quality and efficiency of patient care in different fields, including cataract management. A systematic review of the different applications of AI-based software on all aspects of a cataract patient's management, from diagnosis to follow-up, was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All selected articles were analyzed to assess the level of evidence according to the Oxford Centre for Evidence-Based Medicine 2011 guidelines, and the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation system. Of the articles analyzed, 49 met the inclusion criteria. No data synthesis was possible for the heterogeneity of available data and the design of the available studies. The AI-driven diagnosis seemed to be comparable and, in selected cases, to even exceed the accuracy of experienced clinicians in classifying disease, supporting the operating room scheduling, and intraoperative and postoperative management of complications. Considering the heterogeneity of data analyzed, however, further randomized controlled trials to assess the efficacy and safety of AI application in the management of cataract should be highly warranted.
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Affiliation(s)
- Daniele Tognetto
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Rosa Giglio
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
| | - Alex Lucia Vinciguerra
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Serena Milan
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Robert Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | | | | | | | - Mario Damiano Toro
- Department of Ophthalmology, University of Zurich, Zurich; Department of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland
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Arumuganathan N, Wiest MRJ, Toro MD, Hamann T, Fasler K, Zweifel SA. Acute and subacute macular and peripapillary angiographic changes in choroidal and retinal blood flow post-intravitreal injections. Sci Rep 2021; 11:19381. [PMID: 34588594 PMCID: PMC8481476 DOI: 10.1038/s41598-021-98850-8] [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: 04/10/2021] [Accepted: 07/13/2021] [Indexed: 02/08/2023] Open
Abstract
Whether post injectional acute intraocular pressure (IOP) increase is associated with decreased peripapillary and macular perfusion is still under debate. Here, we investigated early changes in the choroidal and retinal blood flow using OCTA imaging in a cohort of patients undergoing anti-VEGF intravitreal injections (IVI) for macular edema following retinal vein occlusion and diabetic retinopathy. In this prospective single-center, observational study, the pre- and post-IVI changes in retinal perfusion were examined via assessment of vessel length density (VLD) and vessel density (VD) in deep and superficial capillary segmentations (DCP and SCP), foveal avascular zone (FAZ) in SCP, as well as flow signal deficits in the choriocapillaris segmentation. Mean IOP significantly changed over the study course (p = 0.000; ANOVA). Measurements at 5 min post-IVI (33.48 ± 10.84 mmHg) differed significantly from baseline (17.26 ± 2.41 mmHg, p = 0.000), while measurements from one day, one week, and one-month post-IVI did not (p = 0.907, p = 1.000 and p = 1.000 respectively). In comparison to baseline, no changes in OCTA parameters, including FAZ, VD, VLD, and FV, were detected 5 min post-IVI. No significant alterations in OCTA parameters were observed during study course. Increased IOP spikes were detected post-IVI; however, no potential permanent ischemic retinal damage was suspected.
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Affiliation(s)
- Nadhini Arumuganathan
- grid.412004.30000 0004 0478 9977Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, 8006 Zurich, Switzerland
| | - Maximilian Robert Justus Wiest
- grid.412004.30000 0004 0478 9977Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, 8006 Zurich, Switzerland
| | - Mario Damiano Toro
- grid.412004.30000 0004 0478 9977Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, 8006 Zurich, Switzerland ,grid.411484.c0000 0001 1033 7158Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland
| | - Timothy Hamann
- grid.412004.30000 0004 0478 9977Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, 8006 Zurich, Switzerland
| | - Katrin Fasler
- grid.412004.30000 0004 0478 9977Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, 8006 Zurich, Switzerland
| | - Sandrine Anne Zweifel
- grid.412004.30000 0004 0478 9977Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, 8006 Zurich, Switzerland
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Khodriss C, El Harch I, Bennis A, Chraibi F, El Fakir S, Abdellaoui M, Tachfouti N, Benatiya Andaloussi I. [Impact of the SARS-CoV-2 pandemic on diabetic macular edema and prognostic factors]. J Fr Ophtalmol 2021; 44:1313-1318. [PMID: 34538511 PMCID: PMC8421111 DOI: 10.1016/j.jfo.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/05/2021] [Accepted: 07/13/2021] [Indexed: 11/28/2022]
Abstract
But Décrire le retentissement sur l’acuité visuelle et l’épaisseur centromaculaire après arrêt des injections intravitréennes d’anti-VEGF chez les patients diabétiques marocains au cours de la pandémie du Coronavirus. Et étudier les facteurs pouvant être associés à l’aggravation. Matériel et méthodes Cette étude transversale monocentrique a inclus les patients programmés pour injections intravitréennes de Bevacizumab au cours de la période du confinement (20 mars 2020–20 mai 2020) et qui n’en ont pas bénéficié. Ont été recueillis : l’âge, le sexe, l’ancienneté du diabète, le nombre d’injections reçues avant le confinement, l’acuité visuelle en pré-confinement et post-confinement ainsi que l’épaisseur centromaculaire pré-confinement et post-confinement. Résultats Cent cinquante quatre yeux de 104 patients ont été analysés. 57,8 % étaient des hommes avec une moyenne d’âge de 59,4 ± 9,04 ans. La durée moyenne d’arrêt des injections intravitréennes est de 57,3 ± 6,7 jours. Le nombre moyen d’injections intravitréennes de Bevacizumab reçues avant le confinement a été estimé à 2,29 ± 2,1. L’aggravation de l’acuité visuelle a été notée chez 44,8 % de nos patients. Les facteurs associés à l’aggravation fonctionnelle sont le faible nombre d’injections intravitréennes de Bevacizumab reçues avant le confinement (p = 0,001) ainsi que le déséquilibre diabétique (p = 0,04). L’aggravation structurelle a été constatée chez 26,6 % des patients et elle était associée au faible nombre d’injections réalisées avant le confinement (p = 0,038). Conclusion Le report des injections intravitréennes au cours du confinement a eu des effets négatifs sur l’acuité visuelle et l’épaisseur centromaculaire des yeux avec OMD. Un report prolongé des injections intravitréennes d’anti-VEGF chez les patients diabétiques doit être évité.
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Affiliation(s)
- C Khodriss
- Service d'ophtalmologie, hôpital Omar Drissi, CHU Hassan II Fès, faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdellah, 24, RCE sanabil II, Appt2, avenue Mly Hicham, 30050 Fès, Maroc.
| | - I El Harch
- Laboratoire d'épidémiologie, recherche clinique et de santé communautaire, faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdella, Fès, Maroc.
| | - A Bennis
- Service d'ophtalmologie, hôpital Omar Drissi, CHU Hassan II Fès, faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdellah, 24, RCE sanabil II, Appt2, avenue Mly Hicham, 30050 Fès, Maroc.
| | - F Chraibi
- Service d'ophtalmologie, hôpital Omar Drissi, CHU Hassan II Fès, faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdellah, 24, RCE sanabil II, Appt2, avenue Mly Hicham, 30050 Fès, Maroc.
| | - S El Fakir
- Laboratoire d'épidémiologie, recherche clinique et de santé communautaire, faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdella, Fès, Maroc.
| | - M Abdellaoui
- Service d'ophtalmologie, hôpital Omar Drissi, CHU Hassan II Fès, faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdellah, 24, RCE sanabil II, Appt2, avenue Mly Hicham, 30050 Fès, Maroc.
| | - N Tachfouti
- Laboratoire d'épidémiologie, recherche clinique et de santé communautaire, faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdella, Fès, Maroc.
| | - I Benatiya Andaloussi
- Service d'ophtalmologie, hôpital Omar Drissi, CHU Hassan II Fès, faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdellah, 24, RCE sanabil II, Appt2, avenue Mly Hicham, 30050 Fès, Maroc.
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Hsieh TH, Yu HJ, Yang IH, Ho RW, Hsiao YT, Fang PC, Kuo MT. Simultaneously Monitoring Whole Corneal Injury with Corneal Optical Density and Thickness in Patients Undergoing Cataract Surgery. Diagnostics (Basel) 2021; 11:diagnostics11091639. [PMID: 34573979 PMCID: PMC8471687 DOI: 10.3390/diagnostics11091639] [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] [Received: 06/27/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 02/05/2023] Open
Abstract
To pursue the least corneal implication during cataract surgery, this study aimed to monitor corneal wound injury after cataract surgery with a novel method. The prospective cohort study involved thirty-two patients, who were assessed by a Scheimpflug tomography AxL® (Oculus GmbH, Wetzlar, Germany) via the following two kinds of indices: whole corneal optical density (COD) and corneal thickness (CT), two weeks before and one month after cataract surgery. The results of the COD revealed that corneal annuli 0.0–2.0 mm and 2.0–6.0 mm, and the average and maximal values at the incisional site significantly increased postoperatively. Also, the anterior and central stroma of 0.0–2.0 mm, and all three depths of 2.0–6.0 mm, increased remarkably after the operation. For the CT, all ranges of diameters plus incisional sites showed significant increases postoperatively. Furthermore, we analyzed the differences (delta) of COD and CT between pre- and post-operation, and found significant correlations between the delta of COD and the delta of CT, regarding annuli 0.0–2.0 mm, 2.0–6.0 mm, and 6.0–10.0 mm, but no correlation at the incisional site, with either average density or maximal density, was detected. We concluded that whole COD and CT, especially at the central zones of the cornea (annulus < 6 mm), are both valuable parameters in the assessment of corneal damage post-cataract surgery, and are independent indices at the incisional site.
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Affiliation(s)
- Tzu-Han Hsieh
- Department of Medical Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 83301, Taiwan;
| | - Hun-Ju Yu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
| | - I-Hui Yang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
| | - Ren-Wen Ho
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
| | - Yu-Ting Hsiao
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
| | - Po-Chiung Fang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
- Correspondence: (P.-C.F.); (M.-T.K.)
| | - Ming-Tse Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
- Correspondence: (P.-C.F.); (M.-T.K.)
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Dmuchowska D, Cwalina I, Krasnicki P, Konopinska J, Saeed E, Mariak Z, Obuchowska I. The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre. Clin Ophthalmol 2021; 15:3481-3491. [PMID: 34429580 PMCID: PMC8378894 DOI: 10.2147/opth.s323998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/26/2021] [Indexed: 01/10/2023] Open
Abstract
Purpose This study assessed the effect of three waves of the COVID-19 pandemic primarily on the number and timing of referrals due to rhegmatogenous retinal detachment (RRD) and secondarily on the demographic or clinical characteristics of patients. Patients and Methods A retrospective single-centre analysis of medical records included 247 eyes from 247 patients who underwent primary RRD repair with (phaco) vitrectomy between January 1, 2019, and May 31, 2021. Results The percentage of referrals due to primary RRD during the first year of pandemic (March 2020–February 2021) was 16.5% (p=0.179) lower than a year earlier. The percentage of referrals during the first, second and third wave of the pandemic was 48.4%, 18.5% and 26.1% (p=0.029, 0.475, 0.343) lower than in the corresponding months of 2019. A rebound effect was observed only after the first wave. The numbers of referrals in April and May 2021 were similar as in the corresponding months of 2019. No significant differences were observed in the demographic and clinical characteristics of patients admitted before and during the COVID-19 pandemic, other than a tendency towards a higher representation of women, younger persons, longer duration of symptoms but better visual acuity in the latter group. Silicone oil tamponade was used more frequently during the pandemic than before. Conclusion In this study, the COVID-19 pandemic affected the number and timing of referrals due to RRD and the clinical but not demographic characteristics of the patients. The effect lessened with the duration of the pandemic. Previously raised concerns regarding the delay in RRD referrals may no longer be valid during a potential fourth wave of the pandemic. The impact of the pandemic’s waves should be analysed separately, as such an approach provides a better insight into the fluctuations in the number of referrals due to RRD than a year-to-year comparison.
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Affiliation(s)
- Diana Dmuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Izabela Cwalina
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Pawel Krasnicki
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Joanna Konopinska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Emil Saeed
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Zofia Mariak
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Iwona Obuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
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Cataract Surgery by Intraoperative Surface Irrigation with 0.25% Povidone-Iodine. J Clin Med 2021; 10:jcm10163611. [PMID: 34441906 PMCID: PMC8397035 DOI: 10.3390/jcm10163611] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/09/2021] [Accepted: 08/08/2021] [Indexed: 11/16/2022] Open
Abstract
Postoperative endophthalmitis after cataract surgery is typically caused by the patient's own conjunctival normal bacterial flora. A three-step approach is recommended to prevent endophthalmitis: (1) "border control" to prevent microorganisms from entering the eye by disinfecting the ocular surface is the most important measure; (2) bacteria that have gained access into the anterior chamber are reduced by irrigation; (3) bacteria remaining in the anterior chamber and vitreous at the end of surgery are controlled by antibacterial drugs. We have devised a method, "the Shimada technique", for irrigating the ocular surface with povidone-iodine, a disinfectant with potent microbicidal effect and established effective and safe concentrations for eye tissues. Povidone-iodine exhibits a bactericidal effect for a wide concentration range of 0.005-10%, but 0.1% povidone-iodine has the highest activity and requires the shortest time of only 15 s to achieve microbicidal effect. When used to irrigate the ocular surface every 20-30 s during cataract surgery, 0.25% povidone-iodine is conceivably diluted to around 0.1%. Irrigation with 0.25% povidone-iodine during cataract surgery significantly reduced bacteria contamination rate in the anterior chamber compared with saline (p = 0.0017) without causing corneal endothelial damage.
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Impact of Three Waves of the COVID-19 Pandemic on the Rate of Elective Cataract Surgeries at a Tertiary Referral Center: A Polish Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168608. [PMID: 34444356 PMCID: PMC8393808 DOI: 10.3390/ijerph18168608] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/04/2021] [Accepted: 08/13/2021] [Indexed: 12/18/2022]
Abstract
The aim of this study was to assess the effect of three waves of the COVID-19 pandemic on the number of elective cataract surgeries. A retrospective single-center consecutive case series study was performed. We included all 12,464 patients who received cataract surgery in the period between 1 January 2016 and 31 May 2021. Monthly numbers of cataract surgeries during the pandemic were compared with monthly numbers in the reference years 2016–2019. In the pandemic the number of cataract surgeries decreased by 53.4%. The monthly numbers during the first, second and third wave of the pandemic were 77.5%, 51.5% and 29.7% lower, respectively, compared with the reference level. No rebound effect was observed once the pandemic restrictions were eased. Simultaneous bilateral cataract surgeries (SBCS) constituted 6.5% of cataract procedures performed in April and May 2021 compared with 0.77% carried out between May 2019 and March 2021. While the pandemic-affected monthly numbers of cataract surgeries tend to increase recently, they are still below the prepandemic level. Patients should be encouraged to weigh the risks of COVID-19-related morbidity and mortality against the benefits of cataract surgery. Reorganization of the logistics of cataract services is advisable with consideration of SBCS as one of the options.
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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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Aboueshia M, Hussein MH, Attia AS, Swinford A, Miller P, Omar M, Toraih EA, Saba N, Safah H, Duchesne J, Kandil E. Cancer and COVID-19: analysis of patient outcomes. Future Oncol 2021; 17:3499-3510. [PMID: 34263660 PMCID: PMC8284249 DOI: 10.2217/fon-2021-0121] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: We sought to investigate the outcomes associated with COVID-19 disease in cancer patients. Methods: We conducted a retrospective cohort study of laboratory-confirmed COVID-19 patients. Results: Of the 206 patients included, 57 had at least one preexisting malignancy. Cancer patients were older than noncancer patients. Of the 185 discharged cases, cancer patients had a significantly higher frequency of unplanned reintubation (7.1% vs 0.9%, p < 0.049), and required longer hospital stay (8.58 ± 6.50 days versus 12.83 ± 11.44 days, p < 0.002). Regression analysis revealed that obesity and active smoking were associated with an increased risk of mortality. Conclusion: Outcomes in COVID-19 appear to be driven by obesity as well as active smoking, with no difference in mortality between cancer and noncancer patients. In this study, we aimed to investigate how COVID-19 affected cancer patients and whether this altered their survival outcomes. To do this, we examined data from a database of patients who have passed through our institution – a retrospective cohort analysis. Of the 206 patients we included in the study from this database, 57 had at least one preexisting cancer. Cancer patients tended to be older than noncancer patients. Of the 185 discharged patients, cancer patients required longer hospital stays, but there was no difference in mortality. Disease complications and intensive care unit admission with obesity and active smoking put patients in our cohort at increased risk of death. To conclude, outcomes in COVID-19 patients appear to be driven by obesity as well as active smoking, with no difference in mortality between cancer and noncancer patients.
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Affiliation(s)
- Mohamed Aboueshia
- Department of Surgery, Division of Endocrine & Oncologic Surgery, Tulane University, School of Medicine, New Orleans, LA 70112, USA.,Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Mohammad Hosny Hussein
- Department of Surgery, Division of Endocrine & Oncologic Surgery, Tulane University, School of Medicine, New Orleans, LA 70112, USA
| | - Abdallah S Attia
- Department of Surgery, Division of Endocrine & Oncologic Surgery, Tulane University, School of Medicine, New Orleans, LA 70112, USA
| | - Aubrey Swinford
- Tulane University, School of Medicine, New Orleans, LA 70112, USA
| | - Peter Miller
- Tulane University, School of Medicine, New Orleans, LA 70112, USA
| | - Mahmoud Omar
- Department of Surgery, Division of Endocrine & Oncologic Surgery, Tulane University, School of Medicine, New Orleans, LA 70112, USA
| | - Eman Ali Toraih
- Department of Surgery, Division of Endocrine & Oncologic Surgery, Tulane University, School of Medicine, New Orleans, LA 70112, USA.,Department of Histology & Cell Biology, Genetics Unit, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Nakhle Saba
- Section of Hematology & Medical Oncology, Deming Department of Medicine, Tulane University, New Orleans, LA 70112 USA
| | - Hana Safah
- Section of Hematology & Medical Oncology, Deming Department of Medicine, Tulane University, New Orleans, LA 70112 USA
| | - Juan Duchesne
- Trauma/Acute Care & Critical Care, Department of Surgery, Tulane, Tulane School of Medicine, New Orleans, LA 70112, USA
| | - Emad Kandil
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112 USA
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Vawda N, Munsamy A. The Effect of Ocular Perfusion Pressure on Retinal Thickness in Young People with Presumed Systemic Hypotension. Vision (Basel) 2021; 5:36. [PMID: 34287377 PMCID: PMC8293322 DOI: 10.3390/vision5030036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/11/2021] [Accepted: 06/23/2021] [Indexed: 11/17/2022] Open
Abstract
Low ocular perfusion pressure (OPP) may increase the risk of optic neuropathy. This study investigated the effects of OPP on the ganglion cell complex (GCC) and optic nerve head-retinal nerve fibre layer (ONH-RNFL) thickness in presumed systemic hypotensives (PSH). Fifteen participants with PSH and 14 controls underwent automated sphygmomanometry and Icare tonometry to calculate OPP: mean OPP (MOPP), systolic OPP (SOPP), and diastolic OPP (DOPP). ONH-RNFL and macula GCC thickness were evaluated using the Optovue iVue optical coherence tomographer. Statistical analysis comprised independent t-tests, the Mann-Whitney U test and binary logistic regression analysis. There was no significant difference when comparing ONH-RNFL and macula GCC thickness between both groups. Increased MOPP (OR = 0.51; 95% CI: 0.27-0.97; p = 0.039) and SOPP (OR = 0.79; 95% CI: 0.64-0.98; p = 0.035) were significantly associated with a decreased risk of reductions in GCC total thickness. Increased SOPP (OR = 0.11; 95% CI: 0.01-0.89; p = 0.027) was significantly associated with a decreased risk of reductions in the average ONH-RNFL thickness. The study found no significant retinal thickness changes in PSH's, in comparison to the controls. The study established that, by increasing MOPP and SOPP, there was a decreased risk of reductions in the total GCC thickness and average ONH-RNFL thickness. Higher SOPP may decrease the possibility of retinal thinning of the GCC and ONH-RNFL. However, higher MOPP may decrease the odds of thinning of the GCC before ONH-RNFL changes.
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Affiliation(s)
- Naazia Vawda
- Alvin Jeffrey Munsamy, Room E5-642, Discipline of Optometry, 6th Floor, E Block, Westville Campus, University Road, Westville, Durban 3629, South Africa;
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