ABSTRACT
Purpose: To assess the clinical impact and surgical outcomes of a new public vitreo-retinal (VR) service established at Liverpool Hospital, a tertiary trauma referral centre in Sydney, in the context of the COVID-19 pandemic. Method(s): A retrospective surgical audit of all patients who had VR surgery at Liverpool Hospital from January 2020 to January 2021. Result(s): During the inception year of the new service, two surgeons performed 106 operations. Specifically, during the COVID-19 related suspension of elective surgery 22 emergency vitrectomy operations were performed. Of all operations performed, n = 40 (38%) were emergency procedures. The most common pathology was retinal detachment n = 32 (30%), 12 of which had Proliferative vitreoretinopathy at presentation. This was followed by diabetic vitrectomy n = 20 (19%) and nondiabetic vitreous haemorrhage n = 12 (12%). 8 patients had dropped nuclei (5 referred from peripheral hospitals) and 3 patients had endogenous endophthalmitis. Indications for vitrectomy were compared to the UK National Ophthalmology Database Study. Our service performed more operations for diabetic vitrectomy, nondiabetic vitreous haemorrhage and endophthalmitis compared to the UK cohort, while rates of surgery for retinal detachment were similar. At one month postoperatively, uncorrected visual acuity had improved to 6/12 or better in 41 patients (39%). 12 patients (11%) had uncorrected visual acuity worse than 6/60 at the same postoperative period, with limitations identified as PVR re-detachment (5), silicone oil (4), aphakia (2) and corneal scar (1). Conclusion(s): The results of the inaugural year of this VR service demonstrate its viability, despite COVID-19, and clinical results comparable to international standards.
ABSTRACT
Objective: NA Background: The Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), also known as Corona Virus Disease 2019 (COVID-19), pandemic has started at the end of December 2019. Most of the infected patients have presented initially with respiratory symptoms. There is growing evidence of neurological complications with COVID-19 infection. Guillain-Barre Syndrome (GBS), which can exacerbate respiratory symptoms, is one of the neurological complications of COVID-19 infection. We describe here a case of GBS associated with COVID-19 infection. Design/Methods: We describe a case of a 48-year-old female who presented to our hospital with gradually worsening progressive symmetric lower extremities weakness along with numbness and burning pain in the distal lower extremities, 3 weeks after being diagnosed with COVID-19 in another facility. Neurological examination at presentation was significant for bilateral facial muscles weakness, symmetrical and proximal more than distal lower extremities weakness, and loss of deep tendon reflexes in the lower extremities bilaterally. Clinical picture was suspicious for GBS, possibly secondary to COVID-19 infection. Lumbar puncture showed albuminocytologic dissociation and negative PCR for common viral and bacterial pathogens. She was treated with Intravenous Immunoglobulin (IVIG) with significant improvement in her weakness and other symptoms. EMG/NCS was not done during the acute hospital setting in order to limit exposure to COVID-19. Results: NA Conclusions: Our case report presents a patient with GBS as evidence for increasingly recognized potentially disabling neurological complications from COVID-19 infection. The case highlights the importance of early recognition and management.