Presentation, Management, and Outcomes of Rhegmatogenous Retinal Detachments Before and After COVID-19: A Tertiary Center’s Experience
DOI:
https://doi.org/10.48560/rspo.32896Keywords:
COVID-19, Pandemics, Retinal Detachment, VitrectomyAbstract
INTRODUCTION: Our purpose was to compare the presentation, management and outcomes of rhegmatogenous retinal detachments in the same period of 2019, 2020 and 2021.METHODS: Retrospective study that included consecutive patients submitted to surgery for rhegmatogenous retinal detachment at Centro Hospitalar Universitário de Santo António, in April and May of 2019 (Group 1), 2020 (Group 2) and 2021 (Group 3). We evaluated best-corrected visual acuity (LogMAR) at presentation, postoperatively (month 3) and at the last follow-up, macula status at presentation, type of surgery and endotamponade, primary (month 3) and final (last follow-up) anatomical success, time from symptoms’ onset to presentation and from presentation to surgery.
RESULTS: We included 29 eyes in Group 1, 37 in Group 2 and 40 in Group 3. The median time from symptoms’ onset to presentation was 7 [0-30] days in Group 1, 7 [0-21] days in Group 2 and 5 [0-90] days in Group 3 (p=0.752). The median time from presentation to surgery was 2 [1-6] days in Group 1, increasing to 4 [0-10] days in Group 2 (p=0.006) and decreasing to 2 [1-7] days in Group 3 (p<0.001). Macula on was present in 17% in Group 1, 24% in Group 2 and 20% in Group 3 (p=0.207). Pars plana vitrectomy was the most performed surgery (>97%). The most common endotamponade was SF6 in Groups 1 and 3 (61% and 50%, respectively) and C3F8 in Group 2 (61%). There were no differences in the use of silicone oil (p=0.728). Primary and final anatomical successes were similar between groups (p=0.817 and p=0.827, respectively). There were no differences in the preoperative best-corrected visual acuity (p=0.308), and the improvement after treatment was similar (p=0.423).
CONCLUSION: Few differences were found in the presentation, management, and outcomes of rhegmatogenous retinal detachments during April and May 2020, when comparing with the previous and following year. The time from presentation to surgery was longer in 2020, reflecting the re-organization of the health care at the beginning of the COVID-19 pandemic. However, this did not lead to worse visual or anatomical results, showing that the measures implemented were effective and that appropriate care was delivered.
Downloads
References
Recommendations For Urgent and Nonurgent Patient Care [Internet]. American Academy of Ophthalmology. March 2020 [cited September 2023]. Available from: https://www. aao.org/headline/new-recommendations-urgent-nonurgent-patient-care.
Yorston D, Donachie PH, Laidlaw DA, Steel DH, Sparrow JM, Aylward GW, et al. Factors affecting visual recovery after successful repair of macula-off retinal detachments: findings from a large prospective UK cohort study. Eye. 2021;35:1431– 9. doi:10.1038/s41433-020-1021-y
Sothivannan A, Eshtiaghi A, Dhoot AS, Popovic MM, Garg SJ, Kertes PJ, et al. Impact of the time to surgery on visual outcomes for rhegmatogenous retinal detachment repair: a meta-analysis. Am J Ophthalmol. 2022;244:19-29. doi: 10.1016/j. ajo.2022.07.022.
Mitry D, Awan MA, Borooah S, Syrogiannis A, Lim-Fat C, Campbell H, et al. Long-term visual acuity and the duration of macular detachment: findings from a prospective population-based study. Br J Ophthalmol. 2013;97:149-52. doi: 10.1136/bjophthalmol-2012-302330.
De Filippo O, D’Ascenzo F, Angelini F, Bocchino PP, Conrotto F, Saglietto A, et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in northern Italy. N Engl J Med. 2020;383:88-9. doi: 10.1056/NEJMc2009166.
Eshraghian A, Taghavi A, Nikeghbalian S, Malek-Hosseini SA. Reduced rate of hospital admissions for liver-related morbidities during the initial COVID-19 outbreak. Lancet Gastroenterol Hepatol. 2020;5:803-4. doi:10.1016/S2468-1253(20)30207-7
Kapsner LA, Kampf MO, Seuchter SA, Gruendner J, Gulden C, Mate S, et al. Reduced rate of inpatient hospital admissions in 18 German university hospitals during the COVID-19 lockdown. Front Public Health. 2021;8:594117. doi: 10.3389/ fpubh.2020.594117.
Wickham L, Hay G, Hamilton R, Wooding J, Tossounis H, da Cruz L, et al. The impact of COVID policies on acute ophthalmology services-experiences from Moorfields Eye Hospital NHS Foundation Trust. Eye. 2020;34:1189-92. doi: 10.1038/ s41433-020-0957-2.
Holladay JT. Proper method for calculating average visual acuity. J Refract Surg. 1997;13:388-91. doi:10.3928/1081-597X-19970701-16
Hirakata T, Huang T, Hiratsuka Y, Yamamoto S, Inoue A, Murakami A. Clinical patterns of rhegmatogenous retinal detachment during the first state of emergency for the COVID-19 pandemic in a Tokyo center. PLoS One. 2021;16:e0261779. doi:10.1371/journal.pone.0261779
Akram H, Dowlut MS, Karia N, Chandra A. Emergency retinal detachment surgery during Covid-19 pandemic: a national survey and local review. Eye. 2021;35:2889-90. doi:10.1038/ s41433-020-01187-1
Weber C, Stasik I, Holz FG, Liegl R. Impact of COVID-19 before and after 2020 on retinal detachment management in a tertiary eye hospital in Germany. Ophthalmologica. 2022;245:577-87. doi:10.1159/000526171
Dmuchowska D, Cwalina I, Krasnicki P, Konopinska J, Saeed E, Mariak Z, et al. The impact of three waves of the COVID-19 pandemic on the characteristics of primary rhegmatogenous retinal detachments at a tertiary referral centre. Clin Ophthalmol. 2021;15:3481–91. doi:10.2147/OPTH.S323998
Awad M, Poostchi A, Orr G, Kumudhan D, Zaman A, Wilde C. Delayed presentation and increased prevalence of proliferative vitreoretinopathy for primary rhegmatogenous retinal detachments presenting during the COVID-19 pandemic lockdown. Eye. 2021;35:1282-3. doi:10.1038/s41433-020-1056-0
Arjmand P, Murtaza F, Eshtiaghi A, Popovic MM, Kertes PJ, Eng KT. Impact of the COVID-19 pandemic on characteristics of retinal detachments: the Canadian experience. Can J Ophthalmol. 2021;56:88-95. doi:10.1016/j.jcjo.2020.12.008
Mundae R, Velez A, Sodhi GS, Belin PJ, Kohler JM, Ryan EH, et al. Trends in the clinical presentation of primary rhegmatogenous retinal detachments during the first year of the COVID-19 pandemic. Am J Ophthalmol. 2022;237:49-57. doi: 10.1016/j.ajo.2021.11.017.
Li J, Zhao M, She H, Chandra A. The impact of the COVID-19 pandemic lockdown on rhegmatogenous retinal detachment services—Experiences from the Tongren eye center in Beijing. PLOS ONE. 2021;16:e0254751. doi:10.1371/journal. pone.0254751
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Revista Sociedade Portuguesa de Oftalmologia
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Do not forget to download the Authorship responsibility statement/Authorization for Publication and Conflict of Interest.
The article can only be submitted with these two documents.
To obtain the Authorship responsibility statement/Authorization for Publication file, click here.
To obtain the Conflict of Interest file (ICMJE template), click here
