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1.
Klin Monbl Augenheilkd ; 239(4): 476-483, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1830255

ABSTRACT

BACKGROUND: While the corona pandemic and the resulting containment measures affect the number of elective surgical procedures, the impact on emergency surgical interventions is less tangible. This analysis quantifies the frequency of emergency vitrectomies for retinal detachment and investigates underlying factors. METHODS: Retrospective identification of patients who underwent primary emergency vitrectomies for retinal detachment at the Cantonal Hospital of Lucerne between 01.01.2018 - 31.12.2020. Parameters were collected, including demographics, date of hospitalisation, reported onset of symptoms, pre-operative best corrected visual acuity (BCVA), involvement of the macula, and canton of residence. RESULTS: Overall, a total of 665 patients with 683 eyes underwent emergency surgery for primary retinal detachment in the time span of 01.01.2018 - 31.12.2020. Median monthly number of surgeries was 20. During the first Swiss national lockdown (16.03.2020 - 19.04.2020), a minimum of 9 vitrectomies was recorded in March 2020. A maximum of 36 vitrectomies was conducted in August 2020. The mean age of patients was 61.5 years. Of the 665 patients, 133 (20.0%) were residents of the canton of Ticino. Median pre-operative BCVA was 0.25 over all three years, and no significant reduction in pre-operative BCVA was observed during or after the lockdown. The proportion of eyes with involvement of the macula was 52.2%. In 2018, this proportion (47.6%) was significantly lower than in 2019 and 2020 (Chi2 test, p < 0.001). However, cases with macular involvement in post lockdown months were not more frequent. Median time in days from reported symptom onset to hospitalisation was 5 days. In April 2020, the proportion of patients with > 14 days symptom duration was significantly higher (Chi2 test, p < 0.001). During the lockdown, there was a significant reduction in cases from Ticino. Also, patients from Ticino showed proportionally longer symptom duration after the lockdown. CONCLUSION: A significant reduction in the number of emergency vitrectomies was observed for the initial period of the coronavirus pandemic. Delayed emergency presentation is not assumed, since there was no increase in severity (i.e. macular involvement) or prolonged symptoms in the months following the lockdown. More protracted symptoms were only observed in patients from Ticino. The initial low numbers were generally made good later in the year.


Subject(s)
Coronavirus Infections , Coronavirus , Retinal Detachment , Humans , Middle Aged , Pandemics , Retinal Detachment/diagnosis , Retinal Detachment/epidemiology , Retinal Detachment/surgery , Retrospective Studies , Treatment Outcome , Visual Acuity , Vitrectomy/methods
4.
J Fr Ophtalmol ; 45(4): 446-451, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1611835

ABSTRACT

Although ocular toxoplasmosis is usually a self-limiting infection, it can lead to severe reduction in visual acuity due to intense vitreous inflammation or involvement of posterior segment structures. Depending on the severity of intraocular inflammation, serious complications, including epiretinal membrane or retinal detachment may develop. In this paper, we aim to present a case that complicated by both a full-thickness macular hole and retinal detachment secondary to toxoplasmosis chorioretinitis that developed shortly after the novel coronavirus disease (COVID-19) and discuss our treatment approach. After the patient was diagnosed based on a routine ophthalmological examination, fundus imaging, and serological examination, functional and anatomical recovery was achieved through systemic antibiotherapy and vitreoretinal surgery. Full-thickness macular hole and retinal detachment are rare complications of ocular toxoplasmosis. However, there are only few publications in the literature concerning these complications and their surgical treatment. In this case report, we demonstrated the success of vitreoretinal surgery combined with antibiotic therapy on the posterior segment complications of ocular toxoplasmosis.


Subject(s)
COVID-19 , Chorioretinitis , Retinal Detachment , Retinal Perforations , Toxoplasma , Toxoplasmosis, Ocular , COVID-19/complications , Chorioretinitis/complications , Chorioretinitis/diagnosis , Humans , Inflammation/complications , Retinal Detachment/diagnosis , Retinal Detachment/etiology , Retinal Detachment/surgery , Retinal Perforations/diagnosis , Retinal Perforations/etiology , Retinal Perforations/surgery , Tomography, Optical Coherence/adverse effects , Toxoplasmosis, Ocular/complications , Toxoplasmosis, Ocular/diagnosis , Vitrectomy/methods
5.
PLoS One ; 16(12): e0261779, 2021.
Article in English | MEDLINE | ID: covidwho-1594098

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic is disturbing and overwhelming a regular medical care in the world. We evaluated the clinical characteristics of patients with primary rhegmatogenous retinal detachment (RRD) during the state of emergency for COVID-19 pandemic in Japan. We also reviewed measures against the COVID-19 pandemic in our institute with a focus on RRD treatment. Retrospectively, patients who underwent initial RRD surgery during the state of emergency between April 7, 2020 and May 25, 2020 were included. For comparison, we recruited patients who underwent surgery for initial RRD during the same period in the last 2 years (2018 and 2019). Data related to the number of surgeries, age, gender, macular detachment, proliferative vitreoretinopathy (PVR), preoperative visual acuity, surgical techniques, the time between the onset and hospitalization and/or surgery of the 2020 cohort were analyzed and compared with those of the 2018 and 2019 cohorts. Furthermore, we reviewed measures taken against COVID-19 in our institute. The number of RRD patients during the state of emergency tended to be lower than that within the last 2 years. Relatively lesser female (vs. male) patients were observed in the 2020 cohort than in the last 2 years (P = 0.084). In contrast, among all cohorts, no significant differences were observed in the incidence of macula-off and PVR, preoperative visual acuity, and the time period between symptom onset and hospitalization and/or surgery. This is the first report to show the clinical patterns of RRD during COVID-19 pandemic in Japan. Despite the state of emergency for the COVID-19 pandemic, no delay in the patient's initial visit to the hospital and surgery was observed. Further studies, including multicenter researches, are important for investigating the influence of COVID-19 on urgent ocular diseases.


Subject(s)
COVID-19/epidemiology , Pandemics , Retinal Detachment/epidemiology , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective Studies , Tokyo/epidemiology
6.
Adv Ther ; 39(4): 1568-1581, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1530424

ABSTRACT

INTRODUCTION: To explore the impact of coronavirus disease 2019 (COVID-19) on the stability of patients with neovascular age-related macular degeneration (nAMD) receiving the treat and extend (T&E) or the pro re nata (PRN) treatment regimen and to identify indicators that may predict the disease stability of nAMD. METHODS: This is a retrospective study of patients with nAMD treated at the Second Affiliated Hospital of Harbin Medical University whose treatment schedule was interrupted at least once between 1 February and 31 May 2020. The demographic and clinical characteristics, including the best corrected visual acuity (BCVA), optical coherence tomography (OCT) features, subfoveal choroidal thickness (SFCT), interval between the last injection and the beginning of the pandemic, and the number of anti-vascular endothelial growth factor (VEGF) injections, were analyzed. RESULTS: A total of 209 stable patients with nAMD (122 eyes received the T&E regimen; 87 eyes received the PRN regimen) were identified. Compared to those who received the PRN regimen, the patients who received the T&E regimen were more stable during the first visit after COVID-19 (53.3% vs. 33.3%, P = 0.004), the BCVA was significantly better (58.5 letters vs. 56 letters, P = 0.006), and the CRT fluctuated only slightly (15 µm vs. 35 µm, P = 0.001). Furthermore, a multivariate logistic regression analysis showed that stable patients with nAMD with type 1 choroidal neovascularization (CNV) (OR 2.493 [95% CI 1.179-5.272], compared with type 2 CNV; P = 0.017; OR 2.912 [95% CI 1.133-7.485], compared with retinal angiomatous proliferation; P = 0.026) or with pigment epithelial detachment (PED) were more likely to remain stable when treatment was interrupted (OR 0.392 [95% CI 0.181-0.852], compared with no PED; P = 0.018). CONCLUSION: Compared to patients who received the PRN treatment regimen, stable patients with nAMD who received the T&E treatment regimen could better maintain stability when the treatments were suddenly interrupted by the COVID-19 pandemic. In addition, patients with type 1 CNV or patients with PED were more likely to remain stable. At present, the COVID-19 pandemic is becoming increasingly normalized, and the T&E regimen can become a more advanced treatment option for patients undergoing therapy.


Subject(s)
COVID-19 , Choroidal Neovascularization , Macular Degeneration , Retinal Detachment , Wet Macular Degeneration , Angiogenesis Inhibitors/therapeutic use , Choroidal Neovascularization/drug therapy , Humans , Intravitreal Injections , Macular Degeneration/complications , Macular Degeneration/drug therapy , Pandemics , Ranibizumab/therapeutic use , Retrospective Studies , Tomography, Optical Coherence , Treatment Outcome , Vascular Endothelial Growth Factor A/therapeutic use , Visual Acuity , Wet Macular Degeneration/complications , Wet Macular Degeneration/drug therapy
7.
Am J Ophthalmol ; 237: 49-57, 2022 May.
Article in English | MEDLINE | ID: covidwho-1520642

ABSTRACT

PURPOSE: To evaluate the effect of 1 full year of the coronavirus disease 2019 (COVID-19) pandemic on clinical presentation of acute, primary rhegmatogenous retinal detachment (RRD). DESIGN: Single-center, retrospective observational cohort study. METHODS: Patients were divided into 2 cohorts: consecutive patients treated for primary RRD during the COVID-19 pandemic (March 9, 2020, to March 7, 2021; pandemic cohort) and patients treated during the corresponding time in previous year (March 11, 2019, to March 8, 2020; control cohort). MAIN OUTCOME MEASURES: Proportion of patients presenting with macula-involving (mac-off) or macula-sparring (mac-on) RRD. RESULTS: A total of 952 patients in the pandemic cohort and 872 patients in the control cohort were included. Demographic factors were similar. Compared with the control cohort, a significantly greater number of pandemic cohort patients presented with mac-off RRDs ([60.92%] pandemic, [48.17%] control, P = .0001) and primary proliferative vitreoretinopathy ([15.53%] pandemic, [6.9%] control, P = .0001). Pandemic cohort patients (10.81%) had significantly higher rates of lost to follow-up compared with the control cohort (4.43%; P = .0001). Patients new to our clinic demonstrated a significant increase in mac-off RRDs in the pandemic cohort (65.35%) compared with the control cohort (50.40%; P = .0001). Pandemic cohort patients showed worse median final best-corrected visual acuity (0.30 logarithm of the minimum angle of resolution) compared with the control cohort (0.18 logarithm of the minimum angle of resolution; P = .0001). CONCLUSIONS: Patients with primary RRD during the first year of the COVID-19 pandemic were more likely to have mac-off disease, present with primary proliferative vitreoretinopathy, be lost to follow-up, and have worse final best-corrected visual acuity outcomes.


Subject(s)
COVID-19 , Retinal Detachment , Vitreoretinopathy, Proliferative , COVID-19/epidemiology , Humans , Pandemics , Retinal Detachment/diagnosis , Retinal Detachment/drug therapy , Retinal Detachment/epidemiology , Retrospective Studies , Treatment Outcome , Visual Acuity , Vitrectomy
8.
Ophthalmic Surg Lasers Imaging Retina ; 52(11): 593-600, 2021 11.
Article in English | MEDLINE | ID: covidwho-1515569

ABSTRACT

BACKGROUND AND OBJECTIVE: To investigate the effect of the coronavirus disease 2019 (COVID-19) lockdown on the presentation and management of acute, primary rhegmatogenous retinal detachment (RRD). PATIENTS AND METHODS: This was a single-center, consecutive case series with historic controls, examining patients during the COVID-19 "stay-at-home" order (March 24 to June 1, 2020), the subsequent reopening phase (June 1 to July 31, 2020), and corresponding preceding intervals (March 24 to July 31, 2016 to 2019). RESULTS: Despite a significant increase in patients presenting with macula-off RRD during the COVID-19 lockdown compared to the 2016 to 2019 timeframe (P = .03), the rate of single surgery anatomical success was similar between all groups (P = .66), as was final visual acuity (P = .61). No delays between presentation and surgical intervention were observed during the lockdown (P = .49). CONCLUSIONS: Despite the limitations of the COVID-19 lockdown, patients underwent surgery in a timely manner and achieved comparable visual outcomes to controls before COVID-19. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:593-600.].


Subject(s)
COVID-19 , Retinal Detachment , Communicable Disease Control , Humans , Michigan , Retinal Detachment/diagnosis , Retinal Detachment/etiology , Retinal Detachment/surgery , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers , Treatment Outcome , Vitrectomy
9.
J Emerg Med ; 61(6): e146-e150, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1482702

ABSTRACT

BACKGROUND: Although uncommon, retinal detachments are medically urgent and can result in permanent vision loss if untreated. Bilateral retinal detachments in healthy individuals are even more rare. In addition, there are no cases to date of retinal detachment associated with either coronavirus disease 2019 (COVID-19) or after receiving the Moderna (mRNA-1273) severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine. CASE REPORT: A 22-year-old woman with myopia but no ocular trauma or other major medical history presented to the emergency department with 5 days of progressive, painless vision loss in her right eye. On examination, her visual acuity with corrective lenses was 20/70 in the right eye, 20/20 in the left eye, and 20/25 with both eyes open. Point-of-care ultrasound of the eye showed a retinal detachment in the right eye. She was subsequently seen by ophthalmology and diagnosed with bilateral retinal detachments (macula off in the right, macula on in the left), despite being asymptomatic in her left eye. She underwent bilateral vitrectomies for simultaneous rhegmatogenous retinal detachments. Although the patient denied any preceding trauma, she did note having received her second dose of the COVID-19 vaccine 10 days before the onset of symptoms.Why Should an Emergency Physician Be Aware of This? We present a rare and unusual case of simultaneous bilateral retinal detachments in a healthy, young woman with no major medical history or medications. She received the COVID-19 vaccine a few days prior. Our case outlines a possible association with the vaccine and emphasizes the importance of ultrasonography in diagnosing time-sensitive medical conditions.


Subject(s)
COVID-19 , Retinal Detachment , Adult , COVID-19 Vaccines , Female , Humans , Retinal Detachment/etiology , SARS-CoV-2 , Vaccination , Young Adult
10.
BMC Ophthalmol ; 21(1): 372, 2021 Oct 19.
Article in English | MEDLINE | ID: covidwho-1477300

ABSTRACT

BACKGROUNDS: To describe changes in rhegmatogenous retinal detachment (RRD) surgical procedures in Beijing during the COVID-19 Pandemic. METHODS: A retrospective cohort of RRD patients was analyzed. Patients were divided into the COVID-19 pandemic group and pre-COVID-19 group according to their presentation. The presurgery characteristics, surgical procedures, and surgery outcomes were collected. The potential factors related to the choice of pars plana vitrectomy (PPV) or scleral buckling (SB) were analyzed using logistic regression. The differences in the procedure choice under specific conditions were compared. Surgery outcomes were compared between the two groups. RESULTS: In the COVID-19 pandemic group, less patients received SB (27.8, 41.3%, p = 0.02) while more patients received PPV (72.2, 58.6%, p = 0.02); in patients who received SB, fewer patients received subretinal fluid drainage (45.4,75.7%, p = 0.01); in patients who received PPV, fewer patients received phacovitrectomy (7.0, 21.0%, p = 0.02). The choice of PPV was related to older age (1.03, p = 0.005), the presence of RRD with choroidal detachment (RRD-CD) (2.92, p = 0.03), pseudophakia (5.0, p = 0.002), retinal breaks located posterior to the equator (4.87, p < 0.001), macular holes (9.76, p = 0.005), and a presurgery visual acuity (VA) less than 0.02 (0.44, p = 0.03). Fewer phakia patients with retinal breaks located posterior to the equator (1/28, 11/30, p = 0.01) and fewer patients with chronic RRD and subretinal strand (1/9, 9/16, p = 0.03) received SB in the COVID-19 pandemic group. There were more patients with improved VA (55.7, 40.2%, p = 0.03) in the COVID-19 pandemic group. The overall single-surgery retinal attachment rate was similar in the two groups (94.9, 94.5%, p = 0.99). CONCLUSIONS: During the COVID-19 Pandemic, the main reason for the increased number of PPV in RRD treatment was that more complicated cases were presented. However, the surgeons were conservative in procedure choice in specific cases. The adjustments on RRD treatments lead to comparable surgery outcomes.


Subject(s)
COVID-19 , Retinal Detachment , Aged , Humans , Pandemics , Retinal Detachment/epidemiology , Retinal Detachment/surgery , Retrospective Studies , SARS-CoV-2 , Scleral Buckling , Treatment Outcome , Vitrectomy
11.
PLoS One ; 16(3): e0248010, 2021.
Article in English | MEDLINE | ID: covidwho-1388905

ABSTRACT

PURPOSE: To assess the influence of the SARS-CoV-2 lockdown in spring on frequency, severity and quality of care of rhegmatogeneous retinal detachments (RRD) in a tertiary referral center in Vienna, Austria. METHODS: Single center, consecutive case series with historical controls. Patients presenting with primary RRD during the first Austrian SARS-CoV-2 lockdown (March 16th-May 3rd 2020) and a corresponding control group consisting of the same time period of the preceding 3 years. RESULTS: The mean number of patients with RD in the reference group (RG) was 22 (± 1) and in the lockdown group (LG) 15. Median total delay, defined as onset of symptoms until surgery, in the RG was 5 (lower quartile: 3.0; upper quartile: 8.0) compared to 7 (3.0; 12.0) days in the LG, (p = 0.740). During the lockdown 67% of patients were referred from an external ophthalmologist compared to 52% in the RG, (p = 0.395). 34% of patients in the RG presented with an attached macula compared to 33% in the LG (p = 0.597). PVR was present in 49% of cases in the RG compared to 73% in the LG. Single surgery success (SSS) rates were lower in the LG (73.3%) compared to the RG (85.3%), (p = 0.275). CONCLUSION: Patients with RRD during the SARS-CoV-2 lockdown presented and were treated within acceptable time limits, showed the same macula-on ratios but a higher PVR rate and a tendency towards worse SSS rates compared to the time period of the preceding 3 years.


Subject(s)
COVID-19 , Retinal Detachment , Aged , Austria , Female , Humans , Incidence , Male , Middle Aged , Quarantine , Retinal Detachment/epidemiology , Retinal Detachment/surgery , Retrospective Studies , Tertiary Care Centers
12.
Indian J Ophthalmol ; 69(9): 2535-2537, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1371015

ABSTRACT

Rhino-orbital-cerebral mucormycosis is a life-threatening, opportunistic invasive fungal infection. Patients with moderate to severe coronavirus disease 2019 (COVID-19) infection are more vulnerable to it. Varied clinical presentations can be seen in patients with orbital mucormycosis starting from conjunctival chemosis, proptosis, ptosis, restriction of extraocular movements, exposure keratitis, neurotrophic keratitis, and central retinal artery occlusion. Exudative retinal detachment in a patient with orbital mucormycosis is a rare clinical entity. We, hereby, report a case of orbital mucormycosis with exudative retinal detachment in a patient post-COVID-19 infection.


Subject(s)
COVID-19 , Mucormycosis , Orbital Diseases , Retinal Detachment , Humans , Mucormycosis/complications , Mucormycosis/diagnosis , Orbital Diseases/complications , Orbital Diseases/diagnosis , Retinal Detachment/diagnosis , Retinal Detachment/etiology , SARS-CoV-2
13.
PLoS One ; 16(8): e0254751, 2021.
Article in English | MEDLINE | ID: covidwho-1365420

ABSTRACT

PURPOSE: To investigate the impact on services for rhegmatogenous retinal detachment (RRD) patients during the COVID-19 (2019coronal virus disease) pandemic in one tertiary center in Beijing. METHODS: A retrospective cohort study. Two reviewed consecutive RRD patients cohorts of the same length were treated during two different periods: the COVID-19 pandemic and the pre-COVID-19 group. The characteristics of patients, surgery, anesthesia methods, length of hospital stay, and the latest follow-up were recorded and analyzed. RESULTS: There were 79 patients in the COVID-19 pandemic group with a 55.9% reduction (179). Compared to patients in the pre-COVID-19, patients in the COVID-19 pandemic had a longer presurgical waiting times (28days, 3days, p<0.001), a higher percentage of patients with presurgical poor (less than 0.02) visual acuity (55.7%, 32.4%, p = 0.009), and a higher percentage of patients with presurgical choroidal detachment (34.2%, 19.6%, p = 0.01). There was no significant difference in the severity of presurgical proliferative vitreoretinopathy between the two groups (p = 0.64). Surgeries on pathological myopia patients with macular hole retinal detachment were postponed in the COVID-19 pandemic. There was a lower percentage of scleral buckling (27.8%, 41.3%, p = 0.02) and a lower rate of subretinal fluid drainage (45.4%, 75.7%, p = 0.01) in the COVID-19 pandemic. There was no significant difference in either postoperative visual acuity (p = 0.73) or the rate of single-surgery retinal attachment (p = 1) between the two groups. Patients in the COVID-19 pandemic had a shorter length of hospital stay (3hours, 35 hours, p<0.001), and a lower percentage of patients received general anesthesia (48.1%, 83.2%, p<0.001). None was infected with COVID-19 disease during the pandemic. CONCLUSION: The COVID-19 pandemic lockdown caused prolonged presurgical waiting times, shorter hospital stays, less general anesthesia, and a significant reduction of RRD surgeries. The RD were more complicated, the surgeons were more conservative on procedures and patients selection, while the surgery outcomes were comparable.


Subject(s)
COVID-19 , Delivery of Health Care , Length of Stay , Quarantine , Retinal Detachment/surgery , SARS-CoV-2 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , China , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Tertiary Care Centers , Vitreoretinopathy, Proliferative/surgery
14.
BMC Ophthalmol ; 21(1): 215, 2021 May 15.
Article in English | MEDLINE | ID: covidwho-1228991

ABSTRACT

BACKGROUNDS: The COVID-19 Pandemic has a great impact on hospitals and patients. The 14-day quarantine caused surgery of rhegmatogenous retinal detachment (RRD) postponed. We aimed to explore the risk factors of RRD progression in a group of patients whose surgery was postponed during the top-level emergency response of COVID-19. METHODS: A retrospective case series. Medical records of all consecutive patients with a diagnosis of RRD who underwent a surgical treatment at Beijing Tongren Hospital's retina service from February 16, 2020, to April 30, 2020 have been reviewed retrospectively. Medical history, symptoms, and clinical signs of progression of RRD were recorded. RRD progression was defined as the presence of either choroidal detachment or proliferative vitreoretinopathy (PVR) progression during the quarantine period. Risk factors were analyzed using the Cox proportional hazards model, survival analysis, and logistic regression. RESULTS: Seventy-nine eyes of 79 patients met the inclusion criteria and were included in the study. The median time from the patients' presentation at the clinic to admission for surgery was 14 days (3-61 days). There were 70 cases (88.6%) who did not present to the hospital within 1 week of the onset of visual symptoms. There were 69 (87.3%) macular-off cases at the presentation and 27 (34.2%) cases combined with choroidal detachment. There were 49 (62.0%) cases with PVR B, 22 (27.8%) cases with PVR C, 4 (5.1%) cases with PVR D, and 4 (5.1%) cases with anterior PVR. After the 14-day quarantine, 21 (26.6%) cases showed RRD progression, and 9 cases showed RRD regression at the time of surgery. Neither the time of onset of the visual symptom (p = 0.46) nor the time between presentation and admission (p = 0.31) was significantly different between the patients with RRD progression and patients without RRD progression. The combination of choroidal detachment (3.07, 1.68-5.60, p<0.001) and retinal breaks located posterior to the equator (3.79, 1.21-11.80, p=0.02) were factors related to the progression of RRD. CONCLUSIONS: In our study during the COVID-19 outbreak, the RRD progression risk factors included a combination of choroidal detachment and retinal breaks posterior to the equator. Ophthalmologists should schedule the surgeries for RRD patients with these signs as soon as possible.


Subject(s)
COVID-19 , Retinal Detachment , Humans , Pandemics , Quarantine , Retinal Detachment/epidemiology , Retinal Detachment/surgery , Retrospective Studies , Risk Factors , SARS-CoV-2 , Visual Acuity , Vitrectomy
15.
BMJ Case Rep ; 14(4)2021 Apr 28.
Article in English | MEDLINE | ID: covidwho-1207484

ABSTRACT

Tractional retinal detachment is an uncommon complication of intravitreal anti-vascular endothelial growth factor (VEGF) injection wherein the drug triggers tractional retinal detachment as a result of fibrovascular membrane contraction. We present a case of a 42-year-old hypertensive woman diagnosed with chronic central retinal vein occlusion on both eyes. The right eye had total retinal detachment and neovascular glaucoma, while the left eye had retinal neovascularisation. Panretinal photocoagulation and intravitreal anti-VEGF injection was started on the left eye. However, she was lost to follow-up. She returned 4 months later with extensive tractional retinal detachment involving the macula on the left eye. She subsequently underwent vitrectomy with endolaser and silicone oil tamponade on the left eye. The anti-VEGF 'crunch' results from regression of fibrovascular proliferation with a concurrent increase in fibrosis, resulting in worsening retinal traction. With the widespread use of anti-VEGF agents, ophthalmologists need to be aware of this vision-threatening complication.


Subject(s)
Retinal Detachment , Retinal Vein Occlusion , Adult , Female , Humans , Intravitreal Injections , Retinal Detachment/chemically induced , Retinal Detachment/surgery , Vascular Endothelial Growth Factor A , Vitrectomy
16.
Eur J Ophthalmol ; 32(1): 695-703, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1136200

ABSTRACT

BACKGROUND/OBJECTIVES: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). METHODS: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. RESULTS: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65-0.80 and 0.61-0.75, respectively, p < 0.001 for both). CONCLUSION: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.


Subject(s)
COVID-19 , Retinal Detachment , Communicable Disease Control , Humans , Retrospective Studies , SARS-CoV-2
17.
Med Leg J ; 89(2): 102-105, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1127647

ABSTRACT

Recent reports suggest that the use of an outpatient-based procedure (pneumatic retinopexy, PR) for retinal detachment repair should be encouraged within the UK, especially in light of Covid-19 and possible restrictions/competing demands on access to operating theatres. It is therefore essential that patients receive comprehensive information about the risks and benefits of this approach compared with a formal surgical repair either by pars plana vitrectomy (PPV) and/or scleral buckling (SB). We report a retrospective case series of retinal detachments (RD) satisfying the strict selection criteria for PR but who were managed with formal surgery. Single-operation success rate for PPV/SB at six months follow-up was 93.8% in our study, higher than published primary success rates for PR (60-80%). When counselling patients for possible PR, the ease, speed and potentially reduced co-morbidity of an outpatient-based procedure needs to be balanced against its significantly higher failure rate in comparison with primary PPV/SB.


Subject(s)
Informed Consent/standards , Retina/surgery , Retinal Detachment/surgery , Scleral Buckling/standards , Vitrectomy/standards , Aged , COVID-19/prevention & control , COVID-19/transmission , Female , Humans , Informed Consent/legislation & jurisprudence , Male , Middle Aged , Retina/physiopathology , Retrospective Studies , Scleral Buckling/statistics & numerical data , Vitrectomy/statistics & numerical data
18.
BMJ Case Rep ; 14(3)2021 Mar 02.
Article in English | MEDLINE | ID: covidwho-1115106

ABSTRACT

A 47-year-old man presented to our retina clinic with gradual onset diminution of vision in his right eye for the last 3 months. Anterior segment evaluation was normal in both eyes. Fundus evaluation showed the presence of leopard spot appearance in the right eye with inferior exudative retinal detachment. Multimodal imaging was done to evaluate retinal pigment epithelium function, choroidal thickness, choroidal vascularity and scleral thickness. Multimodal imaging showed increased choroidal thickness, choroidal congestion on indocyanine green angiography and peripheral choroidal detachment with normal sclera thickness in our patient, thus pointing towards a diagnosis of uveal effusion syndrome type 3.


Subject(s)
Retinal Detachment , Uveal Effusion Syndrome , Choroid/diagnostic imaging , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Multimodal Imaging , Retinal Detachment/diagnostic imaging , Tomography, Optical Coherence
19.
Ophthalmic Surg Lasers Imaging Retina ; 52(2): 58-60, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1100159
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