The Risk Factors of the Progression of Rhegmatogenous Retinal Detachment on Patients with the Fourteen-day Quarantine in the Early Period of COVID-19 Outbreak

Abstract

Backgrounds: The COVID-19 pandemic has great impact on hospitals and patients. The fourteen-day quarantine caused surgery of RRD postponed. To explore the risk factors of rhegmatogenous retinal detachment (RRD) progression in a group of patients whose surgery was postponed during the top-level emergency response of COVID-19.Methods: Retrospective case series study. The information on RRD patients who received surgeries in Beijing Tongren Hospital's retina service from February 16, 2020, to April 30, 2020 has been collected retrospectively. The history, manifestation on presentation and admission, and progression of RRD were recorded. RRD progression was defined as the presence of either choroidal detachment (CD) or proliferative vitreoretinopathy (PVR) progression during the quarantine period. Risk factors were analyzed using the Cox proportional hazards model, survival analysis, and logistic regression.Results: There were 79 cases enrolled in this study. The median time from the patients' presentation at the clinic to admission for surgery was 14 days (3–61 days). There were 70 cases (88.6%) who did not present to the hospital within one week of the onset of visual symptoms. There were 69 (87.3%) macular-off cases at the presentation. There were 27 (34.2%) cases combined with choroidal detachment. There were 49 (62.0%) cases with PVR B, 22 (27.8%) cases with PVR C, 4 (5.1%) cases with PVR D, and 4 (5.1%) cases with PVR A. After the 14-day quarantine, 21 (26.6%) cases showed RRD progression, and 9 cases showed RD regression at the time of surgery. Neither the time of onset of the visual symptom (p=0.46) nor the time between presentation and admission (p=0.31) was significantly different between the patients with RRD progression and patients without RRD progression. The combination of CD (3.61, 1.86-6.99, p=0.001) and retinal breaks located posterior to the equator (3.78, 1.25-11.45, p=0.02) were factors related to the progression of RRD. Conclusions: In the cases enrolled in our study during the COVID-19 outbreak period, the RRD progression risk factors included a combination of CD and retinal breaks posterior to the equator. Ophthalmologists should schedule the surgeries for RRD patients with these signs as soon as possible.