1
|
Dmitriev AA, Odden J, Mora-Boellstorff D, Kinchington PR, Sheridan K, Viehman JA, Price D, Koscumb S, Marroquin O, Sahel JA, Kowalski RP, Jhanji V, Errera MH. Herpes zoster ophthalmicus: frequency and risk factors for developing uncommon ocular manifestations. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:201-207. [PMID: 37192736 DOI: 10.1016/j.jcjo.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 03/12/2023] [Accepted: 04/24/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To determine the frequency of herpes zoster ophthalmicus (HZO) and assess risk factors for developing uncommon ocular manifestations of laboratory-verified HZO. DESIGN Retrospective cohort study. METHODS The frequency of HZO out of all herpes zoster cases was calculated using International Classification of Diseases codes for patients seen at the University of Pittsburgh Medical Center from January 1, 2004 to October 31, 2021. We also collected demographic and clinical data of patients with HZO identified by polymerase chain reaction (PCR) detection of varicella zoster virus from January 1, 2011 to December 31, 2020. RESULTS The frequency of HZO from 2004 to 2021 in all ages was 4.2% and ranged from 2.7% to 6.7% annually, with a consistent increase of 2.9% from 2012 to 2021. After the live zoster vaccine became available in 2008, the frequency of HZO decreased by 5.1% from 2008 to 2012 in patients aged 60 and older. Among 50 cases of PCR-verified HZO, 62% represented clinically-common ocular manifestations, mostly comprised of 13 cases of keratitis and 10 cases of anterior uveitis. Fifteen cases of acute retinal necrosis (ARN) represented the majority of uncommon HZO manifestations (38%), which were significantly more likely to occur in immunosuppressed patients (unadjusted odds ratio 4.55, 95% confidence interval 1.29-13.83). CONCLUSIONS The overall frequency of HZO from 2004 to 2021 was 4.2% and has increased annually since 2012. Uncommon ocular manifestations of PCR-verified HZO, mostly comprised of ARN, were more likely to occur in immunosuppressed patients.
Collapse
MESH Headings
- Humans
- Herpes Zoster Ophthalmicus/epidemiology
- Herpes Zoster Ophthalmicus/diagnosis
- Herpes Zoster Ophthalmicus/virology
- Retrospective Studies
- Male
- Female
- Risk Factors
- Middle Aged
- Aged
- Eye Infections, Viral/epidemiology
- Eye Infections, Viral/virology
- Eye Infections, Viral/diagnosis
- Adult
- Herpesvirus 3, Human/genetics
- Herpesvirus 3, Human/isolation & purification
- Incidence
- Aged, 80 and over
- Adolescent
- Child
- Young Adult
- Keratitis/epidemiology
- Keratitis/virology
- Keratitis/diagnosis
- Child, Preschool
- Uveitis, Anterior/virology
- Uveitis, Anterior/diagnosis
- Uveitis, Anterior/epidemiology
- Retinal Necrosis Syndrome, Acute/diagnosis
- Retinal Necrosis Syndrome, Acute/virology
- Retinal Necrosis Syndrome, Acute/epidemiology
- Polymerase Chain Reaction
- DNA, Viral/analysis
Collapse
Affiliation(s)
- Aidan A Dmitriev
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA
| | - Jamie Odden
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA
| | | | | | - Kathleen Sheridan
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - John A Viehman
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Danielle Price
- Clinical Analytics, University of Pittsburgh Medical Center Health Services Division, Pittsburgh, PA
| | - Stephen Koscumb
- Clinical Analytics, University of Pittsburgh Medical Center Health Services Division, Pittsburgh, PA
| | - Oscar Marroquin
- Clinical Analytics, University of Pittsburgh Medical Center Health Services Division, Pittsburgh, PA
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA
| | - Regis P Kowalski
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA
| | | |
Collapse
|
2
|
Inoue K, Shiokawa M, Kunimatsu-Sanuki S, Ishida K, Tomita G. Glaucoma progression due to refraining examination amid the pandemic of COVID-19. Int Ophthalmol 2024; 44:196. [PMID: 38662242 DOI: 10.1007/s10792-024-03151-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Some patients refrained from seeking an ophthalmologist due to the anxiety and morbidity associated with the coronavirus disease (COVID-19) pandemic. We investigated progressive visual field defects in patients with glaucoma who refrained from ophthalmological examinations. METHODS This was a retrospective study. We analyzed data from 886 patients with glaucoma who visited Inouye Eye Hospital in June 2022 and were followed-up prior to January 2020. We examined the number of times patients canceled visits between January 2020 and May 2022 due to coronavirus concerns. We assessed the mean deviation (MD) values of the Humphrey Visual Field Assessment (HFA) program 30-2 SITA Standard values after visit interruptions for worsening beyond the MD values predicted by the MD slope. Factors influencing this difference were analyzed using logistic regression analysis. RESULTS The study included 374 men and 512 women. The mean age was 68.7 ± 12.0 years. Visit interruptions occurred in 146 patients (16.5%), with 95 (65.1%) rescheduling once, 27 (18.5%) twice, and 24 (16.4%) three or more times. Among 90 patients who underwent HFA regularly, 50 (55.6%) experienced worse-than-expected MD values and 12 (13.3%) deteriorated by 2 dB or more. Longer interruptions and high intraocular pressure before interruption worsened the MD values by 2 dB or more. CONCLUSION Patients with glaucoma with visit interruptions due to the pandemic should be monitored for the progression of visual field impairment.
Collapse
Affiliation(s)
- Kenji Inoue
- Inouye Eye Hospital, 4-3 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.
| | - Minako Shiokawa
- Inouye Eye Hospital, 4-3 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan
| | | | - Kyoko Ishida
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Goji Tomita
- Inouye Eye Hospital, 4-3 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
| |
Collapse
|
3
|
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.
Collapse
Affiliation(s)
- David Zhao
- Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland.
| | - Ximin Li
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | |
Collapse
|
4
|
Alawadhi A, Palin V, van Staa T. The impact of the COVID-19 pandemic on rates and predictors of missed hospital appointments in multiple outpatient clinics of The Royal Hospital, Sultanate of Oman: a retrospective study. BMC Health Serv Res 2023; 23:1438. [PMID: 38115022 PMCID: PMC10729569 DOI: 10.1186/s12913-023-10395-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The global outbreak of the COVID-19 pandemic resulted in significant changes in the delivery of health care services such as attendance of scheduled outpatient hospital appointments. This study aimed to evaluate the impact of COVID-19 on the rate and predictors of missed hospital appointment in the Sultanate of Oman. METHODS A retrospective single-centre analysis was conducted to determine the effect of COVID-19 on missed hospital appointments at various clinics at The Royal Hospital (tertiary referral hospital) in Muscat, Sultanate of Oman. The study population included scheduled face-to-face and virtual appointments between January 2019 and March 2021. Logistic regression models were used with interaction terms (post COVID-19) to assess changes in the predictors of missed appointments. RESULTS A total of 34, 3149 scheduled appointments was analysed (320,049 face-to-face and 23,100 virtual). The rate of missed face-to-face hospital appointments increased from 16.9% pre to 23.8% post start of COVID-19, particularly in early pandemic (40.5%). Missed hospital appointments were more frequent (32.2%) in virtual clinics (post COVID-19). Increases in missed face-to-face appointments varied by clinic (Paediatrics from 19.3% pre to 28.2% post; Surgery from 12.5% to 25.5%; Obstetrics & Gynaecology from 8.4% to 8.5%). A surge in the frequency of missed appointments was seen during national lockdowns for face-to-face and virtual appointments. Most predictors of missed appointments did not demonstrate any appreciable changes in effect (i.e., interaction term not statistically significant). Distance of patient residence to the hospital revealed no discernible changes in the relative effect pre and post COVID-19 for both face-to-face and virtual clinic appointments. CONCLUSION The rate of missed visits in most clinics was directly impacted by COVID-19. The case mix of patients who missed their appointments did not change. Virtual appointments, introduced after start of the pandemic, also had substantial rates of missed appointments and cannot be viewed as the single approach that can overcome the problem of missing hospital appointments.
Collapse
Affiliation(s)
- Ahmed Alawadhi
- Centre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Victoria Palin
- Centre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
- Maternal and Fetal Research Centre, Division of Developmental Biology and Medicine, The Univeristy of Manchester, St Marys Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Tjeerd van Staa
- Centre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| |
Collapse
|
5
|
Kaur K, Muralikrishnan J, Hussaindeen JR, Deori N, Gurnani B. Impact of Covid-19 on Pediatric Ophthalmology Care: Lessons Learned. Pediatric Health Med Ther 2023; 14:309-321. [PMID: 37849985 PMCID: PMC10578174 DOI: 10.2147/phmt.s395349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
The COVID-19 pandemic came with many new challenges that forced personal and professional lifestyle modifications. Medical facilities were in scarcity against this new unknown enemy and were challenged with the overloaded patient flow, scarcity of healthcare staff, and evolving treatment modalities with a better understanding of the virus each day. Ophthalmology as a "branch of medicine" suffered challenges initially because of a lack of guidelines for patient management, close working distance during routine examinations, and halt of major surgeries, including cataracts. Pediatric ophthalmology had major implications, as reduced outpatient visits would mean deeper amblyopia, and changed lifestyles, including online classes and home refinement, predisposing children to myopia, digital eye strain, and worsening of strabismus. COVID-19 also unveiled underlying accommodation and convergence anomalies that predisposed pediatric and adolescent patients to an increased prevalence of headache and acute onset esotropia. Teleophthalmology and other innovative solutions, including the use of prism glasses, safe slit-lamp shields, alternative ways of school screening with the use of photoscreeners, performing retinoscopy only when needed, and using autorefractors were among the few guidelines or modifications adopted which helped in the efficient and safe management of pediatric patients. Many pediatric ophthalmologists also suffered in terms of financial constraints due to loss of salary or even closure of private practices. School screening and retinopathy of prematurity screening suffered a great setback and costed a lot of vision years, data of which remains under-reported. Important implications and learnings from the pandemic to mitigate future similar situations include using teleophthalmology and virtual platforms for the triage of patients, managing non-emergency conditions without physical consultations, and utilizing home-based vision assessment techniques customized for different age groups. Though this pandemic had a lot of negative implications, the innovations, modifications, and other important learnings helped pediatric ophthalmologists in navigating safely.
Collapse
Affiliation(s)
- Kirandeep Kaur
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Janani Muralikrishnan
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Chennai, India
| | | | - Nilutparna Deori
- Department of Pediatric Ophthalmology and Strabismus, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Bharat Gurnani
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| |
Collapse
|
6
|
Zarranz-Ventura J, Escobar-Barranco JJ, Gómez-Baldó L, Gallego-Pinazo R. Reasons for Delayed Anti-VEGF Treatment During COVID-19 Lockdown and Clinical Impact in Neovascular Age-Related Macular Degeneration. Ophthalmol Ther 2023; 12:2537-2555. [PMID: 37400599 PMCID: PMC10441892 DOI: 10.1007/s40123-023-00757-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/08/2023] [Indexed: 07/05/2023] Open
Abstract
INTRODUCTION Timely anti-vascular endothelial growth factor (VEGF) treatment is crucial for visual function in neovascular age-related macular degeneration (nAMD). The aim of this study was to assess the reasons for anti-VEGF treatment delay during the COVID-19 lockdown and its clinical impact in patients with nAMD. METHODS A retrospective, observational, multicentre study in patients with nAMD treated with anti-VEGF therapy was performed in 16 centres nationwide. Data were retrieved from the FRB Spain registry, patient medical records and administrative databases. Patients were divided into two groups based on whether they received or missed intravitreal injections during the COVID-19 lockdown. RESULTS A total of 302 eyes from 245 patients were included (timely treated group [TTG] 126 eyes; delayed treatment group [DTG] 176 eyes). Visual acuity (VA; ETDRS letters) decreased from baseline to post-lockdown visit in the DTG (mean [standard deviation] 59.1 (20.8) vs. 57.1 (19.7); p = 0.020) and was maintained in the TTG (64.2 [16.5] vs. 63.6 [17.5]; p = 0.806). VA worsened by an average of - 2.0 letters in the DTG and by - 0.6 in the TTG (p = 0.016). A higher proportion of visits were cancelled due to hospital overload in the TTG (76.5%) than in the DTG (47%), and a higher proportion of patients missed visits in the DTG (53%) than in the TTG (23.5%, p = 0.021), with fear of COVID-19 infection being the main reason for missed visits (60%/50%). CONCLUSIONS Treatment delays were caused by both hospital saturation and patients' decision; the latter being mainly driven by fear of COVID-19 infection. These delays had a detrimental effect on the visual outcomes in nAMD patients.
Collapse
Affiliation(s)
- Javier Zarranz-Ventura
- Hospital Clínic of Barcelona, Universitat de Barcelona, C/ Sabino Arana 1, 08028, Barcelona, Spain.
- Institut de Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | | | | | | |
Collapse
|
7
|
Smith JF, Hintze BC, Anderson ST, Tailor PD, Xu TT, Starr MR. Trends in Ophthalmology Practice Consolidation: 2015-2022. Ophthalmology 2023; 130:983-992. [PMID: 37169261 DOI: 10.1016/j.ophtha.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023] Open
Abstract
PURPOSE To quantify trends in ophthalmology practice consolidation in the United States. DESIGN A retrospective cross-sectional study. PARTICIPANTS Providers in the Centers for Medicare and Medicaid Services (CMS) National Downloadable File with a primary specialty designation of ophthalmology. METHODS We used the CMS database to determine national practice consolidation trends in ophthalmology on individual physician and group practice levels and analyzed by region, sex, and years spent in practice. We used the Cochran-Armitage test to determine the statistical significance of practice size differences between 2015 and 2022. MAIN OUTCOME MEASURES Temporal practice size trends for physicians and practices in ophthalmology and regional, sex-specific, and age-related trends. RESULTS Between 2015 and 2022, the number of ophthalmologists decreased from 17 656 to 17 615 (-0.2%), whereas the number of practices decreased from 7149 to 5890 (-18%). The percentage of ophthalmologists in practices of 1 to 2 members decreased from 35% to 28%, whereas those in groups of 50 or more increased from 7% to 11%. The percentage of practices with 1 to 2 members decreased from 75% to 71%, and those with 50 or more increased from 0.2% to 0.4%. Consolidation trends were significant on individual ophthalmologist (P < 0.001) and group practice (P < 0.001) levels. All regions, sexes, and subgroups of years spent in practice demonstrated consolidation (P < 0.001). The Northeast showed the greatest increase in groups of 50 or more physicians (+7%) between 2015 and 2022. Proportionally fewer female than male ophthalmologists were associated with practice sizes of 1 to 2 members in 2015 (29% and 36%, respectively) and 2022 (23% and 30%, respectively). Proportionally fewer ophthalmologists with 0 to 10 years of experience in practice were associated with practice sizes of 1 to 2 members than those with more than 30 years in practice in 2015 (18% and 48%, respectively) and 2022 (14% and 40%, respectively). CONCLUSIONS Ophthalmology has undergone practice consolidation from 2015 to 2022. A decrease in the proportion of physicians affiliated with smaller practice sizes seems to have occurred. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Jacob F Smith
- Department of Ophthalmology, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona
| | - Braden C Hintze
- Department of Neuroscience, Brigham Young University, Provo, Utah
| | - Scott T Anderson
- Department of General Surgery, Mayo Clinic Alix School of Medicine, Jacksonville, Florida
| | | | - Timothy T Xu
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Matthew R Starr
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
| |
Collapse
|
8
|
Acuff K, Delavar A, Radha Saseendrakumar B, Wu JH, Weinreb RN, Baxter SL. Associations between Socioeconomic Factors and Visit Adherence among Patients with Glaucoma in the All of Us Research Program. Ophthalmol Glaucoma 2023; 6:405-412. [PMID: 36746242 PMCID: PMC10400726 DOI: 10.1016/j.ogla.2023.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE To identify socioeconomic factors associated with visit adherence among patients with glaucoma in a nationwide cohort. DESIGN Cross-sectional study. SUBJECTS All subjects were participants in the National Institutes of Health All of Us Research Program. This study cohort consists of participants who were diagnosed with glaucoma and who answered the question on the Health Care Access and Utilization Survey regarding whether they have seen an eye care provider in the last 12 months. METHODS Descriptive analyses were conducted based on participant age, gender, race/ethnicity, insurance status, level of education, and income bracket. Multivariable logistic regression adjusting for these factors was used to generate odds ratios (ORs) for the association between socioeconomic factors and visit adherence. MAIN OUTCOME MEASURE Visit adherence, defined as reporting seeing an eye care provider in the last 12 months. RESULTS Among 4517 patients with glaucoma, 730 (16.3%) indicated that they had not seen or spoken to an eye doctor in the last 12 months. In multivariable models, those with some college education (OR: 1.91; 95% confidence interval [CI]: 1.19-3.04) and those with a college degree or advanced degree (OR: 2.25; 95% CI: 1.39-3.60) and those with the highest annual income of ≥ $200 000 (OR: 1.64; 95% CI: 1.10-2.45) were more likely to have seen an eye doctor in the past year compared with those in the lowest education and income categories, respectively. CONCLUSION Lower income and education levels were significantly associated with lower odds of seeing an eye doctor in the past year among all patients with glaucoma in All of Us. This highlights an important health disparity and may inform subsequent interventions to promote improved adherence to clinical guidelines regarding eye care for glaucoma monitoring and management. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- Kaela Acuff
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Sciences Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Arash Delavar
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Sciences Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Bharanidharan Radha Saseendrakumar
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Sciences Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Jo-Hsuan Wu
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Sciences Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Sally L Baxter
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Sciences Department of Biomedical Informatics, University of California San Diego, La Jolla, California.
| |
Collapse
|
9
|
Zhu A, Tailor P, Verma R, Zhang I, Schott B, Ye C, Szirth B, Habiel M, Khouri AS. Implementation of deep learning artificial intelligence in vision-threatening disease screenings for an underserved community during COVID-19. J Telemed Telecare 2023:1357633X231158832. [PMID: 36908254 PMCID: PMC10014445 DOI: 10.1177/1357633x231158832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Age-related macular degeneration, diabetic retinopathy, and glaucoma are vision-threatening diseases that are leading causes of vision loss. Many studies have validated deep learning artificial intelligence for image-based diagnosis of vision-threatening diseases. Our study prospectively investigated deep learning artificial intelligence applications in student-run non-mydriatic screenings for an underserved, primarily Hispanic community during COVID-19. METHODS Five supervised student-run community screenings were held in West New York, New Jersey. Participants underwent non-mydriatic 45-degree retinal imaging by medical students. Images were uploaded to a cloud-based deep learning artificial intelligence for vision-threatening disease referral. An on-site tele-ophthalmology grader and remote clinical ophthalmologist graded images, with adjudication by a senior ophthalmologist to establish the gold standard diagnosis, which was used to assess the performance of deep learning artificial intelligence. RESULTS A total of 385 eyes from 195 screening participants were included (mean age 52.43 ± 14.5 years, 40.0% female). A total of 48 participants were referred for at least one vision-threatening disease. Deep learning artificial intelligence marked 150/385 (38.9%) eyes as ungradable, compared to 10/385 (2.6%) ungradable as per the human gold standard (p < 0.001). Deep learning artificial intelligence had 63.2% sensitivity, 94.5% specificity, 32.0% positive predictive value, and 98.4% negative predictive value in vision-threatening disease referrals. Deep learning artificial intelligence successfully referred all 4 eyes with multiple vision-threatening diseases. Deep learning artificial intelligence graded images (35.6 ± 13.3 s) faster than the tele-ophthalmology grader (129 ± 41.0) and clinical ophthalmologist (68 ± 21.9, p < 0.001). DISCUSSION Deep learning artificial intelligence can increase the efficiency and accessibility of vision-threatening disease screenings, particularly in underserved communities. Deep learning artificial intelligence should be adaptable to different environments. Consideration should be given to how deep learning artificial intelligence can best be utilized in a real-world application, whether in computer-aided or autonomous diagnosis.
Collapse
Affiliation(s)
- Aretha Zhu
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Priya Tailor
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Rashika Verma
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Isis Zhang
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Brian Schott
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Catherine Ye
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Bernard Szirth
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Miriam Habiel
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Albert S Khouri
- 537707Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| |
Collapse
|
10
|
Cai CX, Tran D, Tang T, Liou W, Harrigian K, Scott E, Nagy P, Kharrazi H, Crews DC, Zeger SL. Health Disparities in Lapses in Diabetic Retinopathy Care. OPHTHALMOLOGY SCIENCE 2023; 3:100295. [PMID: 37063252 PMCID: PMC10090804 DOI: 10.1016/j.xops.2023.100295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/10/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
Objective To develop a novel methodology to identify lapses in diabetic retinopathy care in electronic health records (EHRs) and evaluate health disparities by race and ethnicity. Design Retrospective cohort study. Subjects Adult patients with diabetes mellitus who were evaluated at the Wilmer Eye Institute from January 1, 2013 to April 2, 2022. Methods The methodology to identify lapses in care first identified diabetic retinopathy screening or treatment visits and then compared the providers' recommended follow-up timeframe with the patient's actual time to next encounter. The association of race and ethnicity with odds of lapses in care was evaluated using a mixed-effects logistic regression model controlling for age, sex, insurance, severity of diabetic retinopathy, presence of other retinal disorders, and glaucoma. Main Outcome Measures Lapses in diabetic retinopathy care. Results The methodology to identify diabetic retinopathy-related visits had a 95.0% (95% confidence interval, 93.0-96.6) sensitivity and 98.8% (98.1-99.3) specificity as compared with a gold standard grader. The methodology resulted in a 97.3% (96.2-98.4) sensitivity and 98.1% (97.3-98.9) specificity for detecting a follow-up recommendation, with an average error of -0.05 (-0.31 to 0.21) weeks in extracting the precise timeframe. A total of 39 561 patients with 91 104 office visits were included in the analysis. The average age was 61.4 years. More than 3 (77.6%) in 4 patients had a lapse in care. In multivariable analysis, non-Hispanic Black patients had 1.24 (1.19-1.30) odds and Hispanic patients had 1.26 (1.13-1.40) odds of ever having a lapse in care compared with non-Hispanic White patients (P < 0.001, respectively). Conclusions We have developed a reliable methodology for identifying lapses in diabetic retinopathy care that is tailored to a provider's recommended follow-up. Using this approach, we find that 3 in 4 patients experience a lapse in diabetic retinopathy care and that these rates are higher among non-Hispanic Black and Hispanic patients. Deploying this methodology in the EHR is one potential means by which to identify and mitigate lapses in critical ophthalmic care in patients with diabetes. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- Cindy X. Cai
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
- Correspondence: Cindy X. Cai, MD, 1800 Orleans St, Maumenee Building, Room 711, Baltimore, MD 21287.
| | - Diep Tran
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Tina Tang
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Wilson Liou
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Keith Harrigian
- Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Emily Scott
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Paul Nagy
- Department of Biomedical Informatics and Data Science, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Hadi Kharrazi
- Center for Population Health Information Technology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Deidra C. Crews
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Scott L. Zeger
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
11
|
Meshberg-Cohen S, Farook M, Gross G, Levina V, DeViva J. Treatment utilization and modality preference among veterans receiving outpatient substance use disorder treatment during a pandemic. Am J Addict 2023; 32:32-39. [PMID: 36286598 DOI: 10.1111/ajad.13347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/23/2022] [Accepted: 09/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study examines substance use disorder (SUD) treatment utilization patterns in response to a pandemic. METHOD Retrospective electronic medical record data were collected during three time periods (N = 390): "Pre-COVID-19" (12/02/2019-03/14/2020), "COVID-19" (03/15/2020-06/30/2020), and COVID-19 "Re-entry" (7/01/2020-10/01/2020). Number of visits in each time period, SUD diagnosis, treatment modality (video, telephone, none), demographic, and clinical variables were examined. One-way analyses of variance (ANOVA) and chi-square analyses tested the relationships between treatment modality, demographics, clinical variables, and psychiatric emergency room (PER) visits. Binary logistic regressions examined the effect of treatment modality on PER use during COVID-19 and Re-entry, controlling for alcohol, opioid, and cocaine use disorders, age, and past-year (pre-COVID-19) PER use. RESULTS Treatment modality was associated with SUD (alcohol, cocaine, opioids), age, and PER visits. Veterans who primarily attended telephone appointments were more likely to require PER services compared to those attending video appointments. In the full model, alcohol use disorder (AUD), past-year PER visits, and treatment modality (telephone visits) continued to be significantly associated with COVID-19 PER use, while past-year PER visits correlated with Re-entry PER use. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE During COVID-19, veterans whose main treatment modality was telephone were more likely to require PER services than veterans who were seen by video, even after controlling for age, AUD, opioid use disorder, and past-year PER visits. This study is the first to have examined SUD treatment modality utilization patterns in response to COVID-19. Findings suggest that treatment modality during the initial phase of COVID-19 correlated with PER presentation.
Collapse
Affiliation(s)
- Sarah Meshberg-Cohen
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Minnah Farook
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Georgina Gross
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Victoria Levina
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jason DeViva
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
12
|
Sekimitsu S, Shweikh Y, Zebardast N. Effect of visual impairment on depression and anxiety during the COVID-19 pandemic in the United States. CANADIAN JOURNAL OF OPHTHALMOLOGY 2022:S0008-4182(22)00369-6. [PMID: 36529268 PMCID: PMC9712066 DOI: 10.1016/j.jcjo.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/26/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To evaluate associations between visual impairment, anxiety, and depression during the COVID-19 pandemic in the United States. DESIGN Retrospective cross-sectional design. METHODS This study included a cohort of U.S. adults enrolled in the National Institutes of Health All of Us Research Program. Individuals who were blind/visually impaired (BVI) were identified via Systematized Nomenclature of Medicine (SNOMED) codes and compared with a control cohort. Prevalences of baseline, new, and worsened depression and anxiety, as defined by SNOMED codes and medication use, were compared between the 2 groups. Anxiety and depression during the COVID-19 pandemic were evaluated using the Generalized Anxiety Disorder 7 and the Patient Health Questionnaire 9 surveys, respectively. RESULTS A total of 324,915 participants (7526 BVI individuals and 317,389 control individuals) were included. BVI individuals had higher prevalences of baseline anxiety and depression (50.4% vs 28.7%; p < 0.001), new anxiety and depression (0.98% vs 0.66%; p < 0.001), and worsened anxiety and depression throughout the COVID-19 pandemic (0.19% vs 0.07%; p < 0.001) compared with control individuals. Being BVI was significantly associated with baseline and worsened anxiety and depression after controlling for age, sex, race, ethnicity, and comorbidity (adjusted odds ratio [aOR] = 1.61; 95% CI, 1.46-1.78 and aOR = 2.07; 95% CI, 1.03-4.13). Similarly, being BVI was associated with a 2.07 point increase on the Generalized Anxiety Disorder 7 survey (adjusted β = 2.07; 95% CI, 1.32-3.27) and a 2.96 point increase on the Patient Health Questionnaire 9 survey (adjusted β = 2.96; 95% CI, 1.64-5.36). CONCLUSIONS These findings indicate that BVI individuals were disproportionately affected by anxiety and depression at baseline and throughout the pandemic, highlighting an important need to promote access to mental health services among this population.
Collapse
Affiliation(s)
| | - Yusrah Shweikh
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA; Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Sussex, United Kingdom
| | - Nazlee Zebardast
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA.
| |
Collapse
|
13
|
Chung YG, Person CM, O’Banion J, Primo SA. Coronavirus Disease 2019–Related Health Disparities in Ophthalmology with a Retrospective Analysis at a Large Academic Public Hospital. ADVANCES IN OPHTHALMOLOGY AND OPTOMETRY 2022; 7:311-323. [PMID: 35474943 PMCID: PMC9023339 DOI: 10.1016/j.yaoo.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Tsironi S, Kavvadas D, Delis G, Bekiaridou A, Kapourani V, Loizou F, Apostolidou PS, Misiou K, Theofrastou E, Panakleridou T, Psimenidou E, Sarafi A, Fadel E, Karachrysafi S. Cataract Surgery during the COVID-19 Pandemic: Insights from a Greek Tertiary Hospital. Geriatrics (Basel) 2022; 7:geriatrics7040077. [PMID: 35893324 PMCID: PMC9394252 DOI: 10.3390/geriatrics7040077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/12/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background: COVID-19 has affected everyday clinical practice, having an impact on the quality of healthcare provided, even in eye clinic departments. The aim of this study is to evaluate the consequences of this worldwide pandemic on cataract surgery in a Greek tertiary university hospital. Methods: A total of 805 patients were included in this study. The number of cataract surgeries (CS), the type, the unilateral or bilateral appearance as well as the stage of cataract were recorded for the months between January and June 2019 (pre-COVID period) and compared with the same period in 2021 (during the pandemic outbreak) in the Department of Ophthalmology of Thessaloniki General Hospital G. Papanikolaou. Results: A significant reduction in the number of CS as well as a significant increase in advanced and/or bilateral cataracts in 2021 compared to the pre-COVID period were observed. Conclusions: The COVID-19 pandemic has affected equally the value of ophthalmic interventions as well as the patients’ quality of life, being a powerful reminder of the significant physical and psychological benefits of CS, especially for older adults and patients with comorbidities.
Collapse
Affiliation(s)
- Sevasti Tsironi
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Dimitrios Kavvadas
- Laboratory of Histology-Embryology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Correspondence: (D.K.); (S.K.)
| | - Georgios Delis
- Laboratory of Pharmacology, Faculty of Health Sciences, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Alexandra Bekiaridou
- Laboratory of Histology-Embryology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Viktoria Kapourani
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Fragkeskos Loizou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Panagiota-Sofia Apostolidou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Konstantina Misiou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Efstratios Theofrastou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Thaleia Panakleridou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Eleni Psimenidou
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Anastasia Sarafi
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Elie Fadel
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
| | - Sofia Karachrysafi
- Department of Ophthalmology, General Hospital G. Papanikolaou, 57010 Thessaloniki, Greece; (S.T.); (V.K.); (F.L.); (P.-S.A.); (K.M.); (E.T.); (T.P.); (E.P.); (A.S.); (E.F.)
- Laboratory of Histology-Embryology, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Correspondence: (D.K.); (S.K.)
| |
Collapse
|
15
|
Sim HE, Jeong KD, Hwang JH. Impact of the Coronavirus Disease 2019 Pandemic on the Ophthalmology Department. J Clin Med 2022; 11:jcm11061722. [PMID: 35330047 PMCID: PMC8951152 DOI: 10.3390/jcm11061722] [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: 02/25/2022] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 12/10/2022] Open
Abstract
We aimed to evaluate the effects of the coronavirus disease (COVID-19) pandemic on the Ophthalmology Department. This study was based on data collected between January 2019 and November 2021. We divided patients scheduled for eye care during pre-COVID-19 (January–December 2019), early COVID-19 (January–December 2020), and late COVID-19 (January–November 2021) periods. Changes in the outpatient cancellation rate in each department were analyzed and compared in the pre-, early, and late periods. The basic information of cancellation and reason for not visiting the clinic were also analyzed. Overall, 121,042 patients were scheduled to visit the Sanggye Paik Hospital Ophthalmology Department. The overall cancellation rate was 19.13% during pre-COVID-19, 24.13% during early COVID-19, and 17.34% during late COVID-19. The reasons for not visiting the clinic included hospital, patient, and contact factors; hospitalization in other departments and hospitals; and death. The Strabismus/Pediatric Ophthalmology Department showed the highest cancellation rate of 24.21% over three years. There were no significant differences in the causes of hospital visits by period. The COVID-19 pandemic has caused an overall decrease in the number of ophthalmic outpatients. However, after about a year, the number of outpatients in these departments recovered to the level before the COVID-19 outbreak.
Collapse
Affiliation(s)
- Ha-Eun Sim
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Korea;
| | | | - Je-Hyung Hwang
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Korea;
- Correspondence: ; Tel.: +82-2-950-1101
| |
Collapse
|
16
|
The impact of COVID-19 pandemic and national lockdown on the surgical care of ophthalmic patients in a tertiary health care institution. SRP ARK CELOK LEK 2022. [DOI: 10.2298/sarh220211068v] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction/Objective. World Health Organization in January 2020 declared a pandemic of the coronavirus disease named COVID-19. The state of emergency in the Republic of Serbia began on March 15 2020, which greatly influenced the treatment of those patients who were not affected by COVID-19. The aim of this paper is to compare the most common ophthalmic surgeries during quarantine with those performed in 2019 in the same period. Methods. This is a retrospective study. We collected data from the operating protocol of the main ophthalmic operating room. We have followed the changes related to surgical procedures during these two years. Results. During the state of emergency, significantly more operations were performed on male patients than on female patients compared to the same period in 2019 (p = 0.043). In the observed period, in 2019 significantly more patients older than 65 were surgically treated (p < 0.001). During 2019, there were 397 (64.3%) elective and 220 (35.7%) urgent procedures, while for the same period next year there were 9 (9.1%) elective and 90 (90.9%) urgent procedures. Significantly more urgent interventions were performed during 2020 compared to 2019 (p < 0.001). Conclusion. The coronavirus pandemic has led to numerous changes in the treatment of ophthalmic patients. Many patients did not have access to adequate treatment, which certainly led to the impairment of many ophthalmic diseases.
Collapse
|