Author: André Ferreira (Portugal)
Co-authors: Miguel Afonso, Nisa Silva, Angelina Meireles
Purpose
To describe the impact of COVID-19 pandemic on the presentation characteristics, timings and surgical decisions for primary rhegmatogenous retinal detachment (RD).
Setting/Venue
Retrospective consecutive cohort of rhegmatogenous RD that were submitted to surgery at a tertiary center, Centro Hospitalar Universitário do Porto (CHUPorto), during the year preceding the pandemic and the pandemic year.
Methods
All patients who presented to the Surgical Retina Section at CHUPorto, over a 2-year period were recruited and divided in 2 groups: pre-COVID group, from March 20, 2019 to March 19, 2020; and pos-COVID group, from March 20, 2020 to March 19, 2021. The onset of the COVID-19 pandemic was recorded as starting on March 20, 2020, the same day the first pandemic-related lockdown came to effect in Portugal. Patients were identified by the ICD-9 and ICD-10 codes. Patients were only included if they presented between the specified dates with a primary rhegmatogenous RD and had at least 6 weeks after pars plana vitrectomy (PPV), scleral buckle (SB), or combined PPV and SB given the use of long-acting gas in most surgical cases. Patients were excluded if the affected eye was treated with laser retinopexy for a retinal tear only, or if the affected eye had pre-existing maculopathy, retinopathy, amblyopia, or prior history of serous, tractional or rhegmatogenous RD in the affected eye.
Results
This study enrolled four hundred and forty-nine eyes of 443 patients: 272 in the pre-COVID groups and 177 in the post-COVID one. Of the patients, 63.6% were male and the mean±SD age was 63.0±13.2y (range 13 to 92y). Of the eyes, 55.5% (n = 151) presented with macular detachment in the pre-COVID group compared with 66.9% (n = 119) in the pos-COVID group (odds ratio [OR] 1.62; 95% confidence interval [CI], 1.09-3.86; p=0.016). The time from symptoms onset to hospital admission was longer in the pos-COVID era (median [interquartile range (IQR)]: 7 [3-10] vs 7 [3-15], p=0.021). As well, the time from hospital admission to surgery was also longer during the pandemic year (median [IQR]: 0 [0-2] vs 2 [1-4], p<0.001). PPV was performed in 97.6% of cases and the overall success of interventions (PPV and SB) was 84.2%; no differences between groups. In the pos-COVID, silicone oil (OR 2.03, 95%CI 1.09-3.79, p=0.025) and C3F8 gas (OR 2.42, 95%CI 1.57-3.71, p<0.001) were used more often. No differences were found regarding baseline visual acuity, lens status, trauma or relapse.
Conlusions
The lockdown due to COVID pandemic affected the epidemiology of rhegmatogenous RD, including the macular status at admission and the time since symptoms onset and hospital admission until surgery. Moreover, silicone oil and C3F8 gas were used more often during the pos-COVID year. Despite these contingencies, our Service revealed a quick adaptation to the new scenario as demonstrated by the time of waiting since hospital admission until surgery in the pos-COVID period.
Financial Disclosure
None
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