Trends in the Clinical Presentation of Primary Rhegmatogenous Retinal Detachments During the First Year of the COVID-19 Pandemic

Mundae, Rusdeep; Velez, Adrian; Sodhi, Guneet S; Belin, Peter J.; Kohler, James M.; Ryan, Edwin H.; Tang, Peter H.

doi:10.1016/j.ajo.2021.11.017

Cited by 10 publications

(11 citation statements)

References 26 publications

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“…The number of patients presenting with a macula-on retinal detachment was also lowest during the lockdown period in 2020 (39.2%) as compared to 2019 (50.0%) and 2021 (50.0%). These findings are in accordance with reports from other groups from many regions of the world including Europe, the USA, and Asia [ 21 , 22 , 23 ]. We assume that the slightly lower initial visual acuity reflects the macula status upon first presentation.…”

Section: Discussionsupporting

confidence: 93%

Impact of COVID-19 before and after 2020 on Retinal Detachment Management in a Tertiary Eye Hospital in Germany

et al. 2022

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Introduction COVID-19 has had a tremendous impact on our everyday life. A growing body of evidence indicates that subsequent lockdowns and fear of exposure may have impacted patient care. We analyzed data on incidence and time to surgery in cases of rhegmatogenous retinal detachments (RRD) at three defined time points before, during and one year after the first lockdown period in Germany. Methods In this single center study, we identified all patients who were admitted and treated for a primary RRD in April and May 2020, the time of the first lockdown period in Germany and compared them with cases of the same time period in the years 2019 and 2021. The time from first occurrence of symptoms to surgery as well as visual outcome were analyzed. Results A total of 192 patients presented to our tertiary academic referral center with a RRD during the months of April and May in 2019 (72 patients), 2020 (62 patients) and 2021 (58 patients) and were included in this study. There were no significant differences with regard to gender and age. In 2019 the time interval between occurrence and presentation to our hospital amounted to a mean of 5.96 days and in 2021 to mean of 5.45 days. However, in 2020, the time between occurrence and presentation was significantly longer with a mean of 15.36 days. The number of patients presenting with a macula-on retinal detachment was also lowest in 2020 (39.2%) compared to 2019 (50.7%) and 2021 (50.0%). Furthermore, with 1.24 logMAR the mean BCVA upon initial presentation was lower in 2020 compared to 0.93 logMAR in 2019 and 1.06 logMAR in 2021. Six to twelve weeks following surgery, visual acuity had improved in 56.1% of patients in 2019 and 60.0% of patients in 2021 as compared to 59.0% in 2020 Conclusion We found significant differences in terms of elapsed time from first symptoms to surgical management for patients in 2020 in comparison to the same time period in 2019 and 2021. Less strict lockdown policies appear to impact patient behavior and patient care. Further measures, such as questionnaires, might help to address which measures may provide safer circumstances for patients to consult health care providers in the case of future strict lockdowns.

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Section: Discussionsupporting

confidence: 93%

Impact of COVID-19 before and after 2020 on Retinal Detachment Management in a Tertiary Eye Hospital in Germany

et al. 2022

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“…postoperative visual outcomes of these patients were also significantly worse than before [4][5][6][7].…”

Section: Introductionmentioning

confidence: 81%

TSPAN4-positive migrasome derived from retinal pigmented epithelium cells contributes to the development of proliferative vitreoretinopathy

Yang

et al. 2022

J Nanobiotechnol

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Background Proliferative vitreoretinopathy (PVR) is a blind-causing disease initiated by the activation of retinal pigmented epithelium (RPE) primarily induced by TGF-β families. Migrasome is a recently discovered type of extracellular vesicle related to cell migration. Results Here, we used ex vivo, in vitro, and in vivo models, to investigate the characteristics and functions of migrasomes in RPE activation and PVR development. Results indicated that the migrasome marker tetraspanin-4 (TSPAN4) was abundantly expressed in human PVR-associated clinical samples. The ex vivo model PVR microenvironment is simulated by incubating brown Norway rat RPE eyecups with TGF-β1. Electron microscope images showed the formation of migrasome-like vesicles during the activation of RPE. Further studies indicated TGF-β1 increased the expression of TSPAN4 which results in migrasome production. Migrasomes can be internalized by RPE and increase the migration and proliferation ability of RPE. Moreover, TSPAN4-inhibited RPE cells are with reduced ability of initiating experimental PVR. Mechanically, TSPAN4 expression and migrasome production are induced through TGF-β1/Smad2/3 signaling pathway. Conclusion In conclusion, migrasomes can be produced by RPE under PVR microenvironment. Migrasomes play a pivotal role in RPE activation and PVR progression. Thus, targeting TSPAN4 or blocking migrasome formation might be a new therapeutic method against PVR.

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“…12,13 Most existing studies regarding COVID-19 and RRD have focused on the case volume drop and patient characteristic changes (i.e., delayed presentations). [14][15][16][17][18] Few studies have discussed surgical decision changes. 16,19,20 Li et al 19 observed an increase in the proportion of PPV conducted in Beijing, China, and attributed it to the more complicated cases (e.g., RRD with choroidal detachment) presented.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17][18] Few studies have discussed surgical decision changes. 16,19,20 Li et al 19 observed an increase in the proportion of PPV conducted in Beijing, China, and attributed it to the more complicated cases (e.g., RRD with choroidal detachment) presented. In contrast, Mundae et al 16 observed an increase in SB in Minneapolis-Saint Paul, USA.…”

Section: Introductionmentioning

confidence: 99%

“…16,19,20 Li et al 19 observed an increase in the proportion of PPV conducted in Beijing, China, and attributed it to the more complicated cases (e.g., RRD with choroidal detachment) presented. In contrast, Mundae et al 16 observed an increase in SB in Minneapolis-Saint Paul, USA. In a multicentre study from North America, more in-office pneumatic retinopexy (PR) were chosen for confirmed COVID-19 cases probably owing to the limited access to operating rooms during lockdown.…”

Section: Introductionmentioning

confidence: 99%

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COVID‐19 reduced scleral buckling training in fellows and shifted young ophthalmologists' preference toward vitrectomy: An Asia‐Pacific survey

Wu,

Fung,

Dave

et al. 2023

Clinical Exper Ophthalmology

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BackgroundTo assess rhegmatogenous retinal detachment (RRD) surgery trends and training among young ophthalmologists (YOs, vitreoretinal fellows or attendings/consultants with ≤10 years of independent practice) and the impact of the COVID‐19 pandemic.MethodsAn anonymous online survey was completed by 117 YOs in the Asia‐Pacific regarding their RRD surgery experiences in 2021–2022.ResultsTo achieve a 90% probability of surgical competency, 91 vitrectomy and 34 scleral buckling (SB) completions during fellowship were needed. In total, 49 (41.9%) YOs had fellowship affected by COVID‐19. In the COVID versus pre‐COVID era, however, the volume of SB completions per fellowship year decreased significantly (median [IQR] 3.3 [1.5, 9] vs. 13 [6.5, 23]; p < 0.001) and was lower than the required volume to achieve competency. YOs were less confident in conducting SB versus vitrectomy (3.5 ± 1.1 vs. 4.2 ± 0.8, p < 0.001), and they reported a decrease in the proportion of SB (−3.1%, p = 0.047) and an increase in the proportion of vitrectomy (+4.8%, p < 0.001) after the pandemic outbreak. Apart from RRD clinical characteristics, surgical confidence is among the main factors that affect surgical method decisions. During the pandemic, more YOs may have avoided SB due to the need for general anaesthesia, leading to longer surgical time and risk of viral transmission during intubation/extubation.ConclusionsSB surgical exposure is suboptimal in most fellowship programs in the 11 Asia‐Pacific countries/regions we surveyed and further declined during the COVID‐19 pandemic. YOs are less confident in performing SB, leading to a trend toward primary vitrectomy since the COVID‐19 outbreak.

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Trends in the Clinical Presentation of Primary Rhegmatogenous Retinal Detachments During the First Year of the COVID-19 Pandemic

Cited by 10 publications

References 26 publications

Impact of COVID-19 before and after 2020 on Retinal Detachment Management in a Tertiary Eye Hospital in Germany

Impact of COVID-19 before and after 2020 on Retinal Detachment Management in a Tertiary Eye Hospital in Germany

TSPAN4-positive migrasome derived from retinal pigmented epithelium cells contributes to the development of proliferative vitreoretinopathy

COVID‐19 reduced scleral buckling training in fellows and shifted young ophthalmologists' preference toward vitrectomy: An Asia‐Pacific survey

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