Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Abstract

To evaluate the effect of the coronavirus disease 2019 (COVID-19)-related lockdown in the management of patients with diabetic retinopathy (DR), including diabetic macular edema (DME), in a tertiary reference center in Greece. MethodsIn this retrospective study, we first compared the number of patients who were diagnosed with DR or DME in our clinic during the period of the lockdown and during the same period of the previous year. In addition, we included consecutive patients with DR or DME, who were followed up and treated regularly in our clinic and their appointments deferred due to lockdown, so as to compare the visual acuity, fundoscopy, and optical coherence tomography (OCT) findings prior to and post lockdown. ResultsDuring the lockdown period, there was a statistically significant decrease in patients with DR and DME as compared to the same period in the previous year. Regarding patients with previously diagnosed DME, there was a statistically significant worsening in their visual acuity and central retinal thickness after lockdown as compared to the last visit before lockdown (p<0.001 for both comparisons). Concerning patients diagnosed with DR and without DME before lockdown, 30% of patients with severe non-proliferative diabetic retinopathy (NDPR) and 8.3% of patients with quiescent proliferative DR (PDR) progressed to active PDR while four out of 107 patients (3.7%) developed DME during the lockdown. Multivariate regression analysis revealed that only the time interval between the last visit before lockdown and the first visit after the lockdown was associated with the best-corrected visual acuity (BCVA) change (p=0.017). ConclusionsThe COVID-19-related lockdown was related to the postponement in patient care, which resulted in significantly worse visual acuity outcomes in patients with DR.

Ocular Morbidity among Patients Visiting the Department of Ophthalmology during the Coronavirus Disease 2021 Pandemic at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

“…These findings in the study were comparable with various other studies done elsewhere. [11][12][13][14][15] The findings from the current study also suggested that refractive error (33.7%) and dry eyes (11.7%) are still the leading causes of ocular morbidity in both COVID-19 infected and non-infected study subjects. High prevalence of refractive error, dry eyes and to some extent computer vision syndrome (Table 1) in the study was attributed by the number of hours general population needed to stay at home and work through digital and social media during the pandemic and lockdown, this finding of the study also related well with pre COVID-19 era study done by Bastola P where refractive error and dry eyes were the most prevalent ocular diseases.…”

“…16 The evolution of positive clinical findings due to noncommunicable diseases like hypertension, diabetes mellitus, thyroid eye disorders, classical and common migraine (Table 1, 3) in the study has been explained well by comparable studies done elsewhere. [11][12][13] These findings were supported by the fact that due to COVID-19 pandemic and lockdown measures; the life style of general population was altered and modified which led to a more sedentary life style leading to aggravation of pre-existing hypertension, diabetes and thyroid disorder and new onset diabetic retinopathy and hypertensive retinopathy with mental health issues. In addition, the patients with diabetes and hypertension missed their routine follow ups for Ophthalmic examination during the COVID-19 pandemic and lockdown.…”

“…In addition, the patients with diabetes and hypertension missed their routine follow ups for Ophthalmic examination during the COVID-19 pandemic and lockdown. 13 Not a single COVID- JNMA I VOL 59 I ISSUE 244 I December 2021…”

Management of acute proliferative diabetic retinopathy related complications during the first COVID-19 wave

“…One tertiary centre in Greece described the negative effect on visual acuity and progression to active PDR as a result of deferring appointments during lockdown [ 15 ]. Ghosal et al created a predictive model with regard to diabetic glycaemic control during lockdown using multivariate regression analysis [ 27 ].…”

Effect of COVID-19 Pandemic on Presentation of Patients With Diabetic Retinopathy in a Multitier Ophthalmology Network in India

“…They reported an increased worsening of DR to active PDR post-lockdown. Postponement of care during pandemic was found to be the significant factor for worse visual outcomes [20]. In DME cases, there were unanticipated treatment delays due to lockdown that resulted in worsening and visual impairment [21].…”