ABSTRACT
A 65-year-old male patient presented to the ED complaining of blurred vision in the left eye for the last three days. The patient had just recovered from COVID-19 infection and had a negative polymerase chain reaction (PCR) test two days after the initiation of symptoms. His family and medical history were clear. Ophthalmological examination and imaging revealed branch retinal vein occlusion (BRVO) with macular edema in the left eye, while the right eye was normal. The visual acuity was 6/6 in the right eye and 6/36 in the left eye. Laboratory tests, as well as the full cardiovascular and thrombophilia evaluation, were normal. Since the patient did not have known risk factors for BRVO, we hypothesize that it was related to COVID-19 infection. However, the causality between the two entities remains under investigation.
ABSTRACT
Purpose To evaluate the effect of the coronavirus disease 2019 (COVID-19)-related lockdown in the management of patients with diabetic retinopathy (DR), including diabetic macular edema (DME), in a tertiary reference center in Greece. Methods In this retrospective study, we first compared the number of patients who were diagnosed with DR or DME in our clinic during the period of the lockdown and during the same period of the previous year. In addition, we included consecutive patients with DR or DME, who were followed up and treated regularly in our clinic and their appointments deferred due to lockdown, so as to compare the visual acuity, fundoscopy, and optical coherence tomography (OCT) findings prior to and post lockdown. Results During the lockdown period, there was a statistically significant decrease in patients with DR and DME as compared to the same period in the previous year. Regarding patients with previously diagnosed DME, there was a statistically significant worsening in their visual acuity and central retinal thickness after lockdown as compared to the last visit before lockdown (p<0.001 for both comparisons). Concerning patients diagnosed with DR and without DME before lockdown, 30% of patients with severe non-proliferative diabetic retinopathy (NDPR) and 8.3% of patients with quiescent proliferative DR (PDR) progressed to active PDR while four out of 107 patients (3.7%) developed DME during the lockdown. Multivariate regression analysis revealed that only the time interval between the last visit before lockdown and the first visit after the lockdown was associated with the best-corrected visual acuity (BCVA) change (p=0.017). Conclusions The COVID-19-related lockdown was related to the postponement in patient care, which resulted in significantly worse visual acuity outcomes in patients with DR.