Incidence and surgical care of retinal detachment during the first SARS-CoV-2 lockdown period at a tertiary referral center in Austria

Schranz, Markus; Georgopoulos, Michael; Sacu, Stefan; Reumueller, Adrian; Reiter, Gerhard; Mylonas, Georgios; Schmidt‐Erfurth, Ursula; Pollreisz, Andreas

doi:10.1371/journal.pone.0248010

Cited by 10 publications

(11 citation statements)

References 15 publications

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“…71 While there was a 81% reduction in glaucoma outpatient visits in India, there was a 62% increase in the proportion of glaucoma emergencies. 72 Some studies found a 55-80% decrease in retinal detachment repairs during lockdown periods in 2020, 73,74 but others found a 39% increase for urgent surgeries, such as retinal tears, retinal detachments, and trauma. 75 One study of 82 patients with rhegmatogenous retinal detachments at Wills Eye Hospital found that the patients in 2020 tended to present later than in prior years (20% within a day vs 37%, respectively, P=0.005), were less likely to have their maculas still attached (24% vs 50%, P=0.001), had worse presenting visual acuities (1.00logMAR vs 0.48logMAR, P=0.008), and were more likely to have grade C proliferative vitreoretinopathy (13% PVR vs 5%, P=0.03).…”

Section: Ocular Emergencies and Effects Of Delayed Carementioning

confidence: 99%

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Leung¹,

Fan²,

Flynn³

et al. 2022

OPTH

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There is increasing information available about the effects of the SARS-CoV-2 virus on the systemic and ocular health of patients, as well as the effects of delayed health care. This mini-review summarizes the potential complications and treatments of COVID-19. Systemic findings include respiratory illness, risk of thromboembolic events, and neurologic findings. Some patients may develop persistent symptoms even after the infection resolves. Effective treatment options include glucocorticoids, antivirals, interleukin-6 antagonists, monoclonal antibodies, Janus kinase inhibitors and vaccines. Potential ocular findings of COVID-19 include conjunctivitis, cranial nerve palsies, and microvascular changes in the retina; most symptoms resolved over time. During the lockdown periods, teleophthalmology was utilized to triage non-urgent issues; patients who did present to emergency departments tended to have more severe disease with worse visual prognoses. While transient delays in outpatient ophthalmic care may be tolerated in some patients, others experienced significant vision loss with interruptions in treatments. Resumption of ophthalmic care as soon as possible may help mitigate the effects of delayed care due to the pandemic.

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Section: Ocular Emergencies and Effects Of Delayed Carementioning

confidence: 99%

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Leung¹,

Fan²,

Flynn³

et al. 2022

OPTH

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“…Most published reports of referrals due to RRD during the pandemic centred around the early impact of the first wave. [6][7][8][9][11][12][13][14]17,[21][22][23] To the best of our knowledge, this is the first study to analyse the yearto-year changes in the referrals due to RRD and to verify whether the number and characteristics of patients admitted with this condition changed across the three waves of the COVID-19 pandemic. We also verified whether the periodical lifting of epidemic restrictions was associated with a rebound effect on the referrals.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre

Dmuchowska¹,

Cwalina²,

Krasnicki³

et al. 2021

OPTH

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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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“…A retinal expert or a general ophthalmologist, trained to evaluate disease-specific markers biomicroscopically, might be flooded with additional information provided by the new systems. Especially in times of rising numbers of intravitreal injections, 67 or during the COVID-19 pandemic, 68 a retinal outpatient clinic must strive for the best of care for the individual patient. Telemedicine and real-time evaluation of patients have therefore become even more important.…”

Section: Discussionmentioning

confidence: 99%

Quantitative assessment of retinal fluid in neovascular age-related macular degeneration under anti-VEGF therapy

Reiter

Schmidt–Erfurth

2022

Ophthalmol Eye Dis

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The retinal world has been revolutionized by optical coherence tomography (OCT) and anti-vascular endothelial growth factor (VEGF) therapy. The numbers of intravitreal injections are on a constant rise and management in neovascular age-related macular degeneration (nAMD) is mainly driven by the qualitative assessment of macular fluid as detected on OCT scans. The presence of macular fluid, particularly subretinal fluid (SRF) and intraretinal fluid (IRF), has been used to trigger re-treatments in clinical trials and the real world. However, large discrepancies can be found between the evaluations of different readers or experts and especially small amounts of macular fluid might be missed during this process. Pixel-wise detection of macular fluid uses an entire OCT volume to calculate exact volumes of retinal fluid. While manual annotations of such pixel-wise fluid detection are unfeasible in a clinical setting, artificial intelligence (AI) is able to overcome this hurdle by providing real-time results of macular fluid in different retinal compartments. Quantitative fluid assessments have been used for various post hoc analyses of randomized controlled trials, providing novel insights into anti-VEGF treatment regimens. Nonetheless, the application of AI-algorithms in a prospective patient care setting is still limited. In this review, we discuss the use of quantitative fluid assessment in nAMD during anti-VEGF therapy and provide an outlook to novel forms of patient care with the support of AI quantifications.

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Incidence and surgical care of retinal detachment during the first SARS-CoV-2 lockdown period at a tertiary referral center in Austria

Cited by 10 publications

References 15 publications

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre

Quantitative assessment of retinal fluid in neovascular age-related macular degeneration under anti-VEGF therapy

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