Preoperative COVID-19 RT-PCR Testing of Asymptomatic Patients for Ophthalmic Surgery: Experience from Two Tertiary Referral Centers

Purpose: The aim of this study was to evaluate how prevalent asymptomatic SARS-CoV-2 virus infection (COVID-19) is among patients undergoing ophthalmic surgery at two tertiary referral hospitals. Material(s) and Method(s): This retrospective study included patients without COVID-19 symptoms who underwent preoperative screening using reverse transcription-polymerase chain reaction (RT-PCR) before ophthalmic surgery at the Kocaeli University and Gaziantep University departments of ophthalmology [between September 1, 2020, and December 15, 2020 (group 1);between March 1, 2021, and May 30, 2021 (group 2)]. Patients scheduled for surgery and followed up in the retina, glaucoma, pediatric ophthalmology and strabismus, cataract and refractive surgery, and cornea departments were examined. Result(s): RT-PCR was positive for SARS-CoV-2 in 12 (1.4%) of 840 patients in group 1 and 7 (1.1%) out of 600 patients in group 2. None of the patients were symptomatic of COVID-19. The majority of the patients were scheduled for retina or cataract and refractive surgery in both groups (group 1;retina: 29.2%, cataract and refractive: 57.0%, group-2;retina: 31.3%, cataract and refractive: 54.5%). SARS-CoV-2 RT-PCR testing was positive for seven patients in group 1 (7/245, 2.9%) and five patients in group 2 (5/188, 2.6%) who were scheduled for retinal surgery. Conclusion(s): The necessity, availability, and practicality of COVID-19 RT-PCR testing prior to ophthalmic surgeries varies depending on the protocols of each institution. COVID-19 RT-PCR testing is suggested especially before vitreoretinal surgeries and general anesthesia procedures, because of the difficulty in managing postoperative complications.Copyright © 2023 Gazi Eye Foundation. All rights reserved.

A Product Design Approach to Promote: Psychological Detachment in Remote Work from Home

This research seeks to respond to a current problem, which has to do with the impact of remote work, from home, on the mental health of "knowledge workers” in particular. One of the greatest struggles people report having is being able to disconnect from work, a state known in the field of psychology as Psychological Detachment. In this context, the main objective of this work was to create a product capable of helping people in the process of disconnecting from work at home. To this end, we established an interdisciplinary research where the contribution of psychology stood out. After conducting a literature review, which culminated in the definition of a theoretical framework, we carried out user research, starting with surveys to find out about users who are being affected and concluding this stage with an Ideation workshop where users were encouraged to design solutions to help them disconnect from work. This collaborative and iterative process resulted in a number of ideas emerging alongside the theoretical framework, culminating in the proposal of three product concepts specifically aimed at helping people disconnect. These were subsequently evaluated by users and, according to their perceptions, gathered using User Experience Questionnaire. One of the concepts was chosen for refinement. Due to constraints imposed by the COVID-19 pandemic it was not possible to produce a prototype of this concept for evaluation with users, which limits this study. Obtained results and their implications are discussed. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The role of social support, detachment, and depressive and anxiety symptoms in suicidal thoughts and behaviours during the Covid-19 lockdown: Potential pathways.

During the COVID-19 pandemic, anxiety and depressive symptoms, as well as problems related to social relationships, such as available social support and feelings of detachment from others, have worsened. These factors are strongly associated with suicidal thoughts and behaviours (STB). The effects of feelings of detachment on mental health and on STB have been scarcely studied, together with the relation that it may have with available social support. Therefore, the aim of the present study was to assess potential pathways connecting these conditions. A nationally representative sample of Spanish adults (N = 3305) was interviewed during the COVID-19 pandemic (June 2020). STB, social support, and depressive and anxiety symptoms were measured with the C-SSRS (modified version), OSSS-3, PHQ-8, and GAD-7 scales, respectively. Multivariable logistic regression models and mediation analyses were performed. Social support and some of its components (i.e., social network size and relations of reciprocity) were associated with lower odds of STB. Detachment significantly mediated (22% to 25%) these associations. Symptoms of emotional disorders significantly mediated the association between social support components (29% to 38%) - but not neighbourhood support - with STB, as well as the association between detachment and higher odds of STB (47% to 57%). In both cases, depressive symptoms were slightly stronger mediating factors when compared to anxiety symptoms. Our findings suggest that interventions aimed at lowering depressive and anxiety symptoms, and STB should provide social support and help tackle the feeling of detachment in a complementary way.

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

BACKGROUND: To 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. METHODS: An anonymous online survey was completed by 117 YOs in the Asia-Pacific regarding their RRD surgery experiences in 2021-2022. RESULTS: To 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. CONCLUSIONS: SB 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.

How can employees break free from helplessness in critical work incidents?

Critical incidents, defined as traumatic time-limited events, often happen unexpectedly, and have largely impacted employees in many ways. In this study, we apply the conservation of resources theory as our overarching framework to examine whether and when employees involved in a critical work incident would experience helplessness at work, which may consequently spill over into the life domain and negatively impact their well-being. Taking the COVID-19 as a typical example of critical incidents, we collected multiwave data from 765 Chinese doctors. The results showed that perceived COVID-19 event strength is positively related to doctors' helplessness at work, which further negatively impacts their presence of meaning in life. Besides, meaningful work exacerbates the effect of perceived COVID-19 event strength on doctors' helplessness, while social support and psychological detachment reduce the negative impact of helplessness on their presence of meaning in life. Our study calls attention to protection of the mental health and psychological well-being of employees faced with critical incidents at work and their psychological recovery, and sheds light on the effectiveness of social support and psychological detachment as resource replenishing mechanisms, while cautions against further emphasizing work meaningfulness to employees confronted with a highly novel, disruptive, and critical work event. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Toxic schools? Teacher perceptions of indoor air quality and negative place attachment

The perception of indoor air quality (IAQ) in school buildings has garnered much attention. The self-reported experiences of teachers regarding the phenomenon of suffering from toxic IAQ was missing from scholarly work before the onset of the coronavirus. Toxic IAQ can be defined as the presence of toxic chemicals or compounds (including biological) in the air at levels that pose health risks and can affect a person's health, comfort, and performance (Environmental Protection Agency [EPA], 2018a).Since the onset of the pandemic, teachers are leaving the workforce in unprecedented numbers due to poor working conditions, unreasonable demands, and unrealistic expectations (Steiner & Woo, 2021). Addressing teacher retention is critical to stymie continuing teacher shortages and the adverse impact on students. This sequential mixed-methods study confronts the gap between place theory, specifically the negative emotional person-place bond, and perceived IAQ in public school buildings. Little research has been presented on the role the physical workplace has on teacher well-being and whether psychosociological environmental relationships can predict place attachment outcomes. The question of how teacher perceptions of IAQ relate to negative place attachment was explored using survey research of 242 educators in four public school districts in the Midwest. Survey data was collected April-May of 2021, with 13 follow-up purposive interviews, with the criteria of teachers' presenting negative place attachment feelings, during August 2021. The research revealed the more teachers realize their health concerns about toxic IAQ in their workplace, the more negative place attachment they feel. This involves the process of grieving, and feeling frustrated, angry, exhausted, and confused, like separation and divorce. When a teacher has crossed a threshold of divorced feelings toward the school building, they make choices: to stay employed, assigned to their building, feeling negative place attachment, ask to be reassigned, or leave. The two significant predictors of negative place attachment revealed through stepwise linear regression, were physical "healthy building" attributes and health concerns about the IEQ/IAQ in the school environment. Teachers' perceptions of aged buildings as being unhealthy, including the inoperability of classroom windows, aged carpet, and lack of ventilation were better understood by understanding what it means to occupy a workplace teachers perceive to have toxic IAQ. Employees with health conditions experienced feelings of being misunderstood, not taken seriously, and additionally faced a host of complicated social interactions with their administrators, co-workers, and family because of health ailments they attributed to their workplace. The study resulted in the creation of two new theoretic models: a revisiting of Tripartite Model of Place Attachment to include place detachment, the threshold crossed in absentia of any place attachment feelings, and an epidemiological model for addressing indoor air quality in schools and suggested interventions for practice. While these models help to develop methods, redress, and identification for negative place attachment due to indoor air quality, it was not possible to identify a consistent predictor of negative place attachment. This suggests that the themes identified in the interview process alongside a predictor model can help identify schools where intervention is essential. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

ALL-RUSSIAN CENTER FOR DISASTER MEDICINE "ZASHCHITA" OF FEDERAL MEDICAL AND BIOPHYSICAL CENTER NAMED AFTER A.I. BURNAZYAN OF THE FEDERAL MEDICAL AND BIOLOGICAL AGENCY OF THE RUSSIAN FEDERATION: RESULTS OF WORK IN 2021 AND OBJECTIVES FOR 2022

The need to protect the population of the territories and personnel of the facilities serviced by the Federal Medical and Biological Agency in emergency situations by medical treatment organizations and mobile medical formations sets them an important task — to provide timely emergency and urgent medical care to victims in an emergency in accordance with modern principles of medical evacuation routing. The aim of the study is to analyze and to evaluate the main results of the activities of the All-Russian Center for Disaster Medicine "Zaschita" as a part of Federal Medical and Biophysical Center named after A.I. Burnazyan of the Federal Medical and Biological Agency of the Russian Federation, to develop proposals and to define objectives for further development and improvement of the system to organize medical care and medical evacuation in emergencies at facilities and territories served by FMBA of Russia. Materials and research methods. Materials: regulatory, legal and methodological documents governing the procedure for provid-ing medical aid to the victims of emergencies;reports of the structural units of the All-Russian Center for Disaster Medicine "Zaschita", including special exercises held in 2021;scientific papers on topical issues of medical support to the population in emergencies. Research methods: analytical, statistical, method of direct observation. Results of the study and their analysis. The results of the first year of operation of the the All-Russian Center for Disaster Medicine "Zaschita" as a part of Federal Medical and Biophysical Center named after A.I. Burnazyan of the Federal Medical and Biological Agency of the Russian Federation in 2021 are presented. The following results are considered and analyzed: special trainings of the Field Multidisciplinary Hospital and Consolidated medical detachment;work on medical support of mass events — "Tavrida" Forum of Young Culture and Arts Workers and "Silk Road" international rally. The work of the laboratory of scientific and methodical problems of medical support in emergency situations established in the All-Russian Center for Disaster Medicine "Zaschita" within the past year was characterized. Decrease of the Center of sanitary avia-tion and ambulance services abroad activities due to borders closing, caused by COVID-19 pandemic, is highlighted. The activities of the All-Russian Center for Disaster Medicine "Zaschita" in the field of civil defense in the interests of FMBA of Russia, are listed. The main tasks for the All-Russian Center for Disaster Medicine "Zaschita" for 2022 are formulated. © Burnasyan FMBC FMBA.

Branch Retinal Vein Occlusion Occurring After 2nd Dose of Sinopharm COVID-19 Vaccine: A Case Report

An old-aged woman was evaluated with branch retinal vein occlusion (BRVO) vision reduction in his left eye three weeks after the Sinopharm coronavirus disease 2019 (COVID-19) vaccination. Her best-corrected visual acuity (BCVA) was 1m counting finger in the left eye and 10/10 in the right eye. Initial retinal findings were superior retinal hemorrhage with prominent retinal vein dilation and tortuosity in the left eye. Fluorescein angiography (FA) and optical coherence tomography (OCT) confirmed a BRVO diagnosis. Blood reports showed no abnormalities. Antithrombotic treatment of 80 mg/d low-dose entrocoated ASA was administered. In addition, an intravitreal Aflibercept (Eylea) injection, monthly and ongoing, was prescripted, which led to a decrease in macular edema, retinal hemorrhage, and height of serous retinal detachment. Moreover, the BCVA improved to 2/10 after a three-week follow-up.Copyright © 2023, Journal of Kermanshah University of Medical Sciences.

Socioeconomic and Demographic Factors Contributing to COVID-19-Related Delays and Reductions in Primary Retinal Detachment Repair in a US Hot Spot.

Purpose: This work evaluates demographic and socioeconomic predictors of delayed care for rhegmatogenous retinal detachments (RRDs) during the spring 2020 COVID-19 shutdown in a US hot spot. Methods: This multicenter, retrospective, case-control study took place in 3 academic vitreoretinal practices in metropolitan Boston. Consecutive patients treated for RRD during the COVID-19 state of emergency were compared with patients treated during the same period in 2018 and 2019. The primary outcome was macula status for RRD. Secondary outcomes included visual acuity, symptom duration, proportion with proliferative vitreoretinopathy, time to procedure, method of repair, and patient demographics. Results: The total number of acute RRD decreased by 13.7% from 2018 to 2020 and 17.2% from 2019 to 2020. Symptom duration was significantly longer in 2020 than 2018 and 2019 (median, 7 vs 4 days) with a higher proportion of macula-off detachments (80 of 125 [64%] in 2020 vs 75 of 145 [51.7%] in 2018 and 78 of 151 [51.6%] in 2019). The 2020 cohort included significantly fewer patients in the racial and/or ethnic minority group than in 2019 (P = .02), and use of low-income, government-sponsored health insurance was a predictor of macula-off status during the pandemic (P = .04). Conclusions: RRDs during the spring 2020 COVID-19 lockdown were more likely to be macula-off at presentation. Because sociodemographic factors including race, ethnicity, and income level were associated with deferral of care, ophthalmologists should consider measures targeting vulnerable populations to avoid preventable vision loss as the pandemic continues or in future health care emergencies.

Impact of local COVID-19 alert levels on rhegmatogenous retinal detachment.

PURPOSE: To investigate the impact of the local alert levels regarding coronavirus disease 2019 (COVID-19) on the clinical patterns of rhegmatogenous retinal detachment (RRD) in Japan. STUDY DESIGN: Retrospective, single-center, consecutive case series. METHODS: We compared two groups of RRD patients, a COVID-19 pandemic group and a control group. Based on the local alert levels in Nagano, five periods during the COVID-19 pandemic were further analyzed: epidemic 1 (state of emergency), inter-epidemic 1, epidemic 2 (second epidemic duration), inter-epidemic 2, and epidemic 3 (third epidemic duration). Patients' characteristics, including symptoms' duration before visiting our hospital, macula status, and retinal detachment (RD) recurrence rate in each period, were compared with those in a control group. RESULTS: There were 78 patients in the pandemic group and 208 in the control group. The pandemic group had a longer duration of symptoms than the control group (12.0 ± 13.5 days vs. 8.9 ± 14.7 days, P = 0.0045). During the epidemic 1 period, patients had a higher rate of macula-off RRD (71.4% vs. 48.6%) and RD recurrence (28.6% vs. 4.8%) than the control group. This period also demonstrated the highest rates compared to all other periods in the pandemic group. CONCLUSION: During the COVID-19 pandemic, RRD patients significantly delayed visiting a surgical facility. They showed a higher rate of macula-off and recurrence compared to the control group during the state of emergency than during other periods of the COVID-19 pandemic, although the difference was not statistically significant due to the small sample size.

Using leisure crafting to reduce emotional exhaustion at home during the COVID-19 pandemic through better sleep and not thinking about the pandemic.

Drawing on conservation of resources (COR) theory, we aimed to investigate whether leisure crafting reduces emotional exhaustion by improving sleep quality and strengthening psychological detachment from the coronavirus disease 2019 (COVID-19) pandemic. We posited that sleep quality and psychological detachment from the COVID-19 pandemic mediate the negative relationship between leisure crafting and emotional exhaustion. We carried out a two-wave longitudinal study among a group of individuals (N = 216) from Wuhan, China. We measured leisure crafting, sleep quality, and psychological detachment from the COVID-19 pandemic at Time 1 and emotional exhaustion two months later at Time 2. We discovered that leisure crafting reduced emotional exhaustion at home by improving sleep quality and increasing psychological detachment from the COVID-19 pandemic. At the end of this article, we discuss theoretical and practical implications, research limitations, and directions for future research.

Retinal Detachment and Laser Retinopexy Rates During the COVID-19 Pandemic.

Purpose: At the start of March 2020, the COVID-19 pandemic placed an unprecedented burden on the healthcare system. Throughout much of the United States, shelter-in-place orders were imposed to reduce transmission. A consequence of this crisis, risk mitigation orders, and patient fear of exposure may have led to underutilization of emergency services. We aimed to quantify 2 emergent interventions in ophthalmology, specifically acute laser retinopexy procedures and retinal detachment repair, to determine whether these procedures decreased during the start of the pandemic. Methods: All retinal detachment surgeries and laser retinopexy procedures were identified using Current Procedural Terminology codes. Rate data during the study period (March 1 through May 31, 2020) was compared to historical data from the year prior (March 2019 through May 2019; epoch 1) as well as the immediate 3 months prior to the study period (December 2019 through February 2020; epoch 2). Results: Combined procedures fell by 38.5% (P = .01) and 36.0% (P = .02) when compared to epoch 1 and epoch 2, respectively. The rate of laser retinopexy procedures fell by 45.5% (P = .02) and 33.0% (P = .14) when compared to epoch 1 and epoch 2, respectively. The rate of retinal detachment repair fell by 29.4% (P = .24) and 38.0% (P = .07) when compared to epoch 1 and epoch 2, respectively. Conclusions: Procedures fell during the study period, suggesting underutilization of emergent ophthalmology care. It is necessary for ophthalmologists to emphasize the need to seek care for concerning symptoms.

Effect of the COVID-19 Pandemic on Surgical Outcomes for Rhegmatogenous Retinal Detachments.

We reviewed the medical records of 438 eyes in 431 patients who had undergone surgeries for rhegmatogenous retinal detachments (RRD) or proliferative vitreoretinopathy (PVR ≥ Grade C) to determine whether the COVID-19 pandemic had affected outcomes. The patients were divided into 203 eyes in Group A that had undergone surgery from April to September 2020, during the pandemic, and 235 eyes in Group B that had undergone surgery from April to September 2019, before the pandemic. The pre- and postoperative visual acuity, macular detachment, type of retinal breaks, size of the RRD, and surgical outcomes were compared. The number of eyes in Group A was fewer by 14%. The incidence of men (p = 0.005) and PVR (p = 0.004) was significantly higher in Group A. Additionally, the patients in Group A were significantly younger than in Group B (p = 0.04). The differences in the preoperative and final visual acuity, incidence of macular detachment, posterior vitreous detachment, types of retinal breaks, and size of the RRD between the two groups were not significant. The initial reattachment rate was significantly lower at 92.6% in Group A than 98.3% in Group B (p = 0.004). The COVID-19 pandemic affected the surgical outcomes for RRD with higher incidences of men and PVR, younger aged patients and lower initial reattachment rates even though the final surgical outcomes were comparable.

Sustained impact of COVID-19 on primary retinal detachment repair in a tertiary eye hospital from March to December 2020.

Purpose: To review the sustained effect of COVID-19 on rhegmatogenous retinal detachment (RRD) baseline characteristics and outcomes. Methods: This was a retrospective consecutive case series at the Birmingham and Midlands Eye Centre including patients undergoing primary RRD repair between 23 March and 31 December 2017-2019 (Group 1) and 2020 (Group 2). The deciles of indices of multiple deprivation (IMD) were determined by postcode to group patients into least deprived (IMD1-5) and most deprived (IMD6-10). Results: In total we reviewed 1310 patients, 1003 in Group 1 and 307 in Group 2. Relative to 2017-2019, during the first lockdown, we observed (a) a reduction in the number of patients with RRD, (b) an increase in macula-off detachments, (c) an increase in RRD primary failure, and (d) that the least deprived had proportionately higher primary failure than the most deprived (p = 0.049) with a higher detachment rate than the pre-COVID-19 period (p = 0.010) and increased presentations of macula-off detachment. During the second lockdown, these differences were not observed. Conclusion: The previously observed findings of lower presentation rates of RRD during the beginning of the first lockdown and the decreased number of macula-on RRD were not sustained over a longer period of observation or found to recur after a second national lockdown. Patients from areas with the least socioeconomic deprivation seemed to be more negatively affected by the first lockdown, with later presentation and higher rates of re-detachments compared with the most deprived during the first lockdown. Our findings offer reassurance that patient behaviour and health services had adapted to the pandemic by the second national lockdown. Supplementary Information: The online version of this article (10.1007/s00717-022-00521-0) contains supplementary material, which is available to authorized users.

Research on the Influencing Factors and Mechanism of Smartphone Use and Addiction on Employees: A Systematic Review

In recent decades, new technologies have reshaped people's working environment. Both organizations and individuals have benefited a lot from these new technologies. However, everything is two-sided, which means the development of various new technologies in the work scene, such as smartphones, has had a series of negative effects on employees' job performance and their physical and mental health. Researchers generally regard smartphone addiction in the work scene as a behavioral addiction in a specific environment. The formation of employees' smartphone addiction is affected by many factors, in which psychological factors belonging to endogenous factors and working environment factors belonging to exogenous factors are significant. Besides, in the past three years, the outbreak and popularity of COVID-19 accelerates formation of employees' smartphone addiction. The influence of smartphones addiction on employees had advantages and disadvantages while it is generally believed that the disadvantages, which have numerous negative effects on employees' physical and psychological health, personal life, family and job performance, outweigh the advantages. The mechanism of psychological smartphone addiction can be explained by job demand - resource theory and boundary theory. In the future, we still need to pay attention to the influencing mechanism of smartphone addiction and employees' job performance and figure out the key influencing factors, so as to amplify the advantages of using smartphones in the work scene and make smartphone serve to the target of improving job performance.

How can employees break free from helplessness in critical work incidents?

Critical incidents, defined as traumatic time-limited events, often happen unexpectedly, and have largely impacted employees in many ways. In this study, we apply the conservation of resources theory as our overarching framework to examine whether and when employees involved in a critical work incident would experience helplessness at work, which may consequently spill over into the life domain and negatively impact their well-being. Taking the COVID-19 as a typical example of critical incidents, we collected multiwave data from 765 Chinese doctors. The results showed that perceived COVID-19 event strength is positively related to doctors' helplessness at work, which further negatively impacts their presence of meaning in life. Besides, meaningful work exacerbates the effect of perceived COVID-19 event strength on doctors' helplessness, while social support and psychological detachment reduce the negative impact of helplessness on their presence of meaning in life. Our study calls attention to protection of the mental health and psychological well-being of employees faced with critical incidents at work and their psychological recovery, and sheds light on the effectiveness of social support and psychological detachment as resource replenishing mechanisms, while cautions against further emphasizing work meaningfulness to employees confronted with a highly novel, disruptive, and critical work event.

Evaluating retinal microvascular changes in COVID-19 using wide-field swept-source optical coherence tomography angiography

Purpose : The effects of COVID-19 on the retina have been debated since the start of the pandemic. This study aims to assess how COVID-19 may alter retinal microvasculature using wide-field swept-source optical coherence tomography angiography (WF SS-OCTA). Methods : This prospective, cross-sectional, observational study included patients with a positive COVID-19 polymerase chain reaction (PCR) test who underwent WF SS-OCTA imaging from August 2020 to November 2021. The mean days from PCR diagnosis to imaging was 175.6. Age-matched controls included healthy eyes and fellow eyes of retinal detachment, retinal tears, retinal artery occlusion, and retinal vein occlusion. Patients with diabetes, uncontrolled hypertension, retinal disease, prior retinal surgery, and a positive COVID-19 test >365 days before imaging were excluded. Vessel density (VD) and vessel skeletonized density (VSD) were calculated (Macular Density Algorithm v0.7.3.3, ARI Network) for the superficial capillary plexus (SCP), deep capillary plexus (DCP), and whole retina using 3x3, 6x6, and 12x12 mmscans centered on the fovea. A mixed-effect multivariate multilevel linear regression model was used to identify any difference between controls and COVID-19 groups. Results : 34 eyes of 29 patients with COVID-19 and 54 eyes of 45 controls were included. Generalized reductions in VD and VSD were seen in COVID-19 eyes compared to controls (Fig 1). Controlling for age, COVID-19 was associated with a statistically significant overall reduction in VD in the SCP and whole retina in 3x3 mmand DCP of 6x6 mm scans as well as decreased VSD in the DCP in 6x6 mm scans(Table 1). Looking at changes by region, COVID-19 eyes had significant reductions in superior sectors in VD across all scan sizes and layers except the whole retina in 6x6 mm scans, and in VSD across all scan sizes and layers except the SCP in 3x3 and 6x6 mm scans and whole retina in 6x6 mm scans. Additional region-specific reductions in VD and VSD were seen in the DCP in 6x6 and 12x12 mm scans, whole retina in 12x12 mmscans, and SCP in 12x12 mmscans. Conclusions : Patients with COVID-19 showed reduced VD and VSD compared to controls. This may indicate that there are some retinal microvasculature changes in patients with prior COVID-19 infection. (Figure Presented).

Impact of government-imposed lockdown due to the COVID-19 Pandemic on admissions and severity of retinal detachments in a referral eye hospital in Germany

Purpose : To analyze the patient characteristics and severity of retinal detachments (RDs) in a referral eye hospital during the COVID-19 pandemic with a corresponding timeline a year before. Methods : Retrospective cohort study based on electronic patient records of all patients with confirmed diagnosis of RD from February 22, 2020 (lockdown imposed by German Government) to May 4, 2020 (end of lockdown) and following 2 weeks after lockdown period (LP) in the Department of Ophthalmology, Helios Dr. Horst Schmidt Klinikum (HSK), Wiesbaden, Germany, were analyzed and compared to the equivalent pre-COVIDperiod (p-Cp) from February 22, 2019, to May 4, 2019). Results : During LP 26 patients were diagnosed with RD compared to 60 patients in the pCp (-56.7%, p<0.01). Within 2 weeks after LP a total of 13 with RD were admitted. A year before, two weeks after p-Cp 26 patients with RD were admitted, respectively (-50%, p<0.01). There was no statistical difference in age between LP group and p-Cp group (65.3±11.5 vs. 69.1±12.3 years (p>0.05)). Time between initial symptoms and ophthalmological examination was significantly longer in LP group (p<0.01). While usage of gas tamponade and silicone oil tamponade was similar in both LP and p-Cp group, there was a significant increase of proliferative vitreoretinopathy (PVR) RD needing silicone oil tamponade within two weeks after LP ended in Germany (LP 53.8% vs. p-Cp 23.1%) (p<0.01). Conclusions : During government-imposed lockdown caused by COVID-19 pandemic, the rate of patients admitted with RD dropped significantly compared to the same p-Cp. Time between initial symptoms and ophthalmological examination was significantly longer in LP group, with consecutively more PVR-RD needing silicone oil tamponade within the following two weeks after lockdown period ended. While policymakers have focused primarily on containing chains of infection with SARS-CoV-2, it has had a massive impact on the medical care of ophthalmic emergencies with worsening prognosis after retinal detachment.

Analyzing the effect of the COVID-19 pandemic on patient outcomes following keratorefractive surgery

Purpose : To evaluate the impact of the COVID-19 pandemic on keratorefractive surgery outcomes by comparing rates of post-operative complications prior to and during the pandemic. Methods : A retrospective cohort study was conducted using TriNetX (Cambridge, MA, USA), a federated electronic health records research network comprising multiple large health organizations in the United States. Patients were identified based on using validated CPT procedure codes for keratorefractive Surgery and were separated into two cohorts based on if they received their procedure before the pandemic protocols (Jan 1, 2019-Mar 17, 2020) or during the pandemic (Mar 18, 2020 to Dec 1, 2020). Then, 1:1 propensity score matching was utilized to create two same-sized cohorts which matched for various demographic and medical conditions. Subsequently, the relative risk for 11 specific post-operative complications between was compared between the two cohorts. Relative risks between cohorts were calculated and outcomes with p<0.05 were considered statistically significant. Results : A total of 2,626 patients were included in analysis with 1,313 in each of the prepandemic and pandemic cohorts after propensity matching. Dry eye had a greater risk (RR 1.29;95 Cl, 0.94, 1.77) among the pandemic cohort, however the results were not statically significant (P>0.113). Similarly, retinal detachment was observed to have a lower risk (RR 0.83;95% Cl, 0.36, 1.92) among the pandemic cohort but the results were not statistically significant either (P >0.663). No statistically significant differences in the remaining post-operative complications were observed including recurrent corneal erosion, secondary corneal erosion, corneal scar/opacity, diffuse lamellar keratitis, corneal neovascularization, vitreous degeneration and hemorrhage, retinal edema, and cystoid macular degeneration. Conclusions : The COVID-19 pandemic undoubtedly affected surgical practice of many ophthalmologists, and many operating rooms adopted new protocols after safety concerns for surgeons and ancillary staff. The results show that there was no statistically significant difference in the rate of post-operative complications for patients undergoing keratorefractive surgery before and during the pandemic. This suggests that despite the new safety protocols implemented in operating rooms, the quality-of-care patients received during the pandemic was not impacted.

Impact of COVID-19 on ophthalmic surgery in Australia

Purpose : The effect of coronavirus disease 2019 (COVID-19) on ophthalmic surgical case numbers in Australia and globally remains poorly characterised. Increased incidence of COVID-19 in Australia between March and April 2020 led to a national lockdown and elective surgery restrictions. The aim of this population-based study was to quantify the early impact of COVID-19 on ophthalmic surgery in Australia, comparing surgical service rates in 2019 and 2020. Methods : Retrospective analysis of the number of ophthalmic surgical services in 2019 and 2020 in all Australian States and Territories, as recorded by Medicare (Australian Government-funded universal health insurance scheme subsidising healthcare costs for Australian residents). Monthly surgical service rates were calculated and Poisson regression was used to compare the change in service rates between months. Results : Between March and April 2020, surgical service rates decreased for: cataract surgery (by 71%, 95% CI: 70-72%), cataract surgery with minimally invasive glaucoma surgical device insertion (by 71%, 95% CI: 65-75%), pterygium removal (by 67%, 95% CI: 60- 72%), corneal transplantation (by 31%, 95% CI: 9-48%), and collagen crosslinking for corneal ectasias (by 35%, 95% CI: 18-48%). Comparatively, service rates for these surgeries did not differ or decreased less between March and April 2019. Interestingly, glaucoma filtration surgery rates decreased between March and April in 2020 (by 44%, 95% CI: 29- 56%) and also in 2019 (by 45%, 95% CI: 31-55%), whilst retinal detachment surgery rates were unchanged between these months in 2020 (crude decrease 9%, 95% CI: -28 to 16%) and 2019 (crude decrease 11%, 95% CI: -26 to 9%). Conclusions : Despite relatively low rates of COVID-19 community transmission in Australia in 2020, ophthalmic surgical service rates decreased during months in lockdown and with restrictions, largely for non-time-critical conditions. These data may have health planning implications as the pandemic continues, with future lockdowns and restrictions possible, especially as COVID-19 variants emerge.