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1.
Am J Ophthalmol ; 242: 7-17, 2022 10.
Article in English | MEDLINE | ID: covidwho-1850565

ABSTRACT

PURPOSE: Evaluate factors associated with coronavirus 2019 (COVID-19) vaccine hesitancy and clinical trends in primary rhegmatogenous retinal detachments (RRDs) during the first year of vaccine availability. DESIGN: Single-center, clinical cohort study. METHODS: Consecutive patients from December 14, 2020, to December 12, 2021, presenting vaccinated (Prior-), subsequently vaccinated (Later-), or remaining unvaccinated (Never-Vax). Primary outcome was proportion with macula-off (mac-off) RRD. Secondary outcomes included logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), primary proliferative vitreoretinopathy (PVR), proportion lost to follow-up, and distance traveled. RESULTS: 1047 patients were divided into 391 Prior-, 252 Later-, and 404 Never-Vax cohorts. Significantly greater proportions of Later- and Never-Vax cohorts presented with mac-off RRDs (Prior-Vax = 44.5%; Later-Vax = 54%, P < .0001; Never-Vax = 57.9%, P < .0001) and primary PVR (Prior-Vax = 4.3%; Later-Vax = 13.6%, P < .0001; Never-Vax = 17.1%, P < .0001) compared to Prior-Vax cohort. Significantly greater proportion of Never-Vax cohort (7.7%, P < .0001) were lost to follow-up compared to Prior- (2.3%) and Later-Vax (2.2%) cohorts. Never-Vax cohort (median = 35 miles) traveled farther compared to Prior- (median = 22.3 miles; P < .0001) and Later-Vax cohorts (25.45 miles; P = .0038). Prior-Vax cohort had significantly better (P < .05) initial (median = 0.30 logMAR) and final (0.18 logMAR) BCVA compared to Later- (Initial: 0.54 logMAR; Final: 0.30 logMAR) and Never-Vax (Initial: 0.70 logMAR; Final: 0.40 logMAR) cohorts. CONCLUSIONS: COVID-19 vaccine hesitancy is associated with worse clinical presentation and outcomes for primary RRD.


Subject(s)
COVID-19 , Retinal Detachment , Vitreoretinopathy, Proliferative , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Cohort Studies , Humans , Retinal Detachment/diagnosis , Retinal Detachment/etiology , Retinal Detachment/surgery , Retrospective Studies , Treatment Outcome , Vaccination Hesitancy , Visual Acuity , Vitrectomy
2.
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
3.
Ocul Immunol Inflamm ; 30(5): 1250-1254, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1784140

ABSTRACT

PURPOSE: To report a case of Vogt-Koyanagi-Harada (VKH) disease following mRNA-1273 (Moderna) COVID-19 vaccination. METHODS: Retrospective case report. RESULTS: A 50-year-old Korean woman developed bilateral serous retinal detachment 35 days after the first dose of COVID-19 mRNA vaccination (mRNA-1273, Moderna). She experienced adverse effects such as erythema and pain at the injection site, headache, myalgia, and allergy symptoms prior to ocular manifestation. She was diagnosed with Vogt-Koyanagi-Harada (VKH) disease. After treatment with oral prednisolone, the serous retinal detachment resolved and vision improved. CONCLUSION: COVID-19 vaccination might be associated with VKH disease development, and the ingredients of the mRNA vaccine or viral peptide encoded by mRNA may have activated the immunological process and induced VKH disease.


Subject(s)
2019-nCoV Vaccine mRNA-1273 , COVID-19 , Retinal Detachment , Uveomeningoencephalitic Syndrome , Female , Humans , Middle Aged , 2019-nCoV Vaccine mRNA-1273/adverse effects , COVID-19/prevention & control , Prednisolone/therapeutic use , Retinal Detachment/chemically induced , Retinal Detachment/diagnosis , Retinal Detachment/diet therapy , Retrospective Studies , Uveomeningoencephalitic Syndrome/diagnosis , Uveomeningoencephalitic Syndrome/drug therapy , Uveomeningoencephalitic Syndrome/etiology , Vaccination/adverse effects
4.
Ophthalmol Retina ; 6(7): 638-641, 2022 07.
Article in English | MEDLINE | ID: covidwho-1751161

ABSTRACT

In this retrospective, multicenter study of 261 eyes (259 patients), patients who underwent rhegmatogenous retinal detachment repair during the coronavirus disease 2019 (COVID-19) post-lockdown period experienced an additional 22-day delay, leading to significantly more epiretinal membrane and proliferative vitreoretinopathy and lower single-surgery anatomic success rates. During lockdown, perfluoropropane gas was used more commonly, and pneumatic retinopexy was used more commonly in COVID-19-positive patients.


Subject(s)
COVID-19 , Retinal Detachment , COVID-19/epidemiology , Communicable Disease Control , Humans , Retinal Detachment/diagnosis , Retinal Detachment/surgery , Retrospective Studies , Treatment Outcome , Visual Acuity
5.
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
6.
Am J Ophthalmol ; 237: 49-57, 2022 05.
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
7.
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
8.
Ophthalmologica ; 245(2): 111-116, 2022.
Article in English | MEDLINE | ID: covidwho-1484152

ABSTRACT

PURPOSE: This study aimed to describe the impact of COVID-19 pandemic on the presentation characteristics, timings, and surgical decisions for primary rhegmatogenous retinal detachment (RRD). METHODS: A historical cohort including all patients who presented to the Surgical Retina Section at Centro Hospitalar Universitário do Porto (CHUPorto), over a 2-year period, was recruited and divided into 2 groups: pre-COVID and COVID groups. The onset of the COVID-19 pandemic was recorded as starting on March 18, 2020, the same day the first pandemic-related lockdown came to effect in Portugal. RESULTS: This study enrolled 449 eyes of 443 patients: 272 in the pre-COVID group and 177 in the COVID one. Of the patients, 63.6% were male, and the mean ± SD age was 63.0 ± 13.2 years (range 13-92 years). Of the eyes, 55.5% (n = 151) presented with macular detachment in the pre-COVID group compared with 66.9% (n = 119) in the COVID group (odds ratio [OR] 1.62; 95% confidence interval [CI]: 1.09-3.86; p = 0.016). The time from symptom onset to hospital admission (p = 0.021) and from admission to surgery (p < 0.001) was longer in the COVID era. In the COVID period, 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 in anatomical success or final visual acuity were found. CONCLUSIONS: The lockdown due to COVID pandemic affected the epidemiology of RRD. The services must adapt to the novel reality and produce backup plans for similar events. Despite the contingencies, the final results were not different between groups.


Subject(s)
COVID-19 , Retinal Detachment , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Communicable Disease Control , Female , Humans , Male , Middle Aged , Pandemics , Retinal Detachment/diagnosis , Retinal Detachment/epidemiology , Retinal Detachment/surgery , Retrospective Studies , Vitrectomy , Young Adult
9.
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
10.
Ophthalmic Surg Lasers Imaging Retina ; 52(1): 47-49, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-1038700

ABSTRACT

Posterior pigment dispersion is a rare ophthalmic finding that has been reported in patients undergoing retinectomy with silicone oil placement and in patients who underwent significant anterior segment manipulation and vitrectomy. The pigment release is believed to occur from retinal pigment epithelium (RPE) cells in the former and the posterior iris in the latter. The exact timing of this pre-retinal pigment deposition is unknown but typically is mild and occurs over several months. A rapid progression of diffuse preretinal pigmentation is uncommon and may be suggestive of persistent RPE release from an open break or continued iris trauma with posterior pigment release. This report describes a case of profound posterior pigment deposition more than 4 months after retinectomy and oil in a patient with a persistently open retinectomy edge with anterior retinal detachment. The rapidity of pigment deposition was the clue to recognizing this subtle anterior detachment under silicone oil. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:47-49.].


Subject(s)
Retinal Detachment , Humans , Pigmentation , Retina , Retinal Detachment/diagnosis , Retinal Detachment/surgery , Silicone Oils , Vitrectomy , Vitreous Body
11.
Ophthalmology ; 128(5): 686-692, 2021 05.
Article in English | MEDLINE | ID: covidwho-857049

ABSTRACT

PURPOSE: To investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on the clinical presentation of acute, primary rhegmatogenous retinal detachment (RRD). DESIGN: Single-center, consecutive case series with historical controls. PARTICIPANTS: Consecutive patients seeking treatment for primary RRD in a 50-day period during the COVID-19 pandemic (March 9-April 27, 2020) and the corresponding 50-day period during the previous year (March 4-April 22, 2019) in the United States. METHODS: The cohorts were compared to assess demographic variables and clinical presentations. Multivariate logistic regression was used to identify factors predictive of presenting macular attachment status. MAIN OUTCOME MEASURES: The primary outcome was the proportion of patients with macula-on RRD at presentation. Secondary outcomes included visual acuity (VA), duration of symptoms before presentation, proportion seeking treatment within 1 day of symptom onset, and presence of primary proliferative vitreoretinopathy (PVR). RESULTS: Eighty-two patients were included in the 2020 cohort compared with 111 patients in the 2019 primary control cohort. Demographic factors were similar between the groups. Significantly fewer patients demonstrated macula-on RRD in the 2020 cohort (20/82 patients [24.4%]) than in the 2019 cohort (55/111 patients [49.5%]; P = 0.001). Patients in the 2020 cohort showed worse median VA at presentation (1.00 logarithm of the minimum angle of resolution [logMAR; Snellen equivalent, 20/200] in 2020 vs. 0.48 logMAR [Snellen equivalent, 20/60] in 2019; P = 0.008), fewer patients sought treatment within 1 day of symptoms (16/80 patients [19.5%] in 2020 vs. 41/106 patients [36.9%] in 2019; P = 0.005), and a greater proportion demonstrated primary PVR (11/82 patients [13.4%] in 2020 vs. 5/111 patients [4.5%] in 2019; P = 0.03). In multivariate analysis, younger age (P = 0.03) and established patient status (P = 0.02) were independent predictors of macula-on status in the 2020 cohort. CONCLUSIONS: Patients with primary RRD during the 2020 COVID-19 pandemic were less likely to have macula-on disease and more likely to delay seeking treatment and to show worse vision and PVR.


Subject(s)
COVID-19/epidemiology , Pandemics , Retinal Detachment/surgery , Scleral Buckling/methods , Visual Acuity , Comorbidity , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retinal Detachment/diagnosis , Retinal Detachment/epidemiology , Retrospective Studies , SARS-CoV-2 , Treatment Outcome
12.
Ophthalmologe ; 118(7): 670-674, 2021 Jul.
Article in German | MEDLINE | ID: covidwho-840909

ABSTRACT

BACKGROUND: Retinal detachment is an ophthalmological emergency. Delayed diagnostics and treatment increase the risk of permanent loss of vision. Current media reports have suggested that patients with medical emergencies delay seeking treatment out of fear of being infected with the corona virus SARS-CoV­2. This study analyzed data from a German university hospital to determine if the coronavirus pandemic had an impact on treatment and visual outcomes of patients with retinal detachment. METHODS: In this study 60 patients treated for rhegmatogenous retinal detachment in the eye hospital of the University Hospital Hamburg-Eppendorf between 15 March and 5 May 2020 were retrospectively analyzed. Patients from the corresponding period of the previous year acted as a control group. Significant differences between the groups were investigated by hypothesis testing. RESULTS: When compared to the period in the previous year there were no significant differences for sex, age, eye, length of symptoms, previous visit to doctor, visual acuity, macula status, degree of retinal detachment, proliferative vitreoretinopathy and type or length of procedure during the coronavirus pandemic. Of the patients with retinal detachment 29% had general health concerns due to the coronavirus pandemic. CONCLUSION: Medical treatment for retinal detachment was not influenced by the coronavirus pandemic. In contrast to other medical emergencies the morbidity of retinal detachment did not increase and admitted cases did not decrease during the pandemic when compared to the same period in the previous year.


Subject(s)
COVID-19 , Retinal Detachment , Hospitals, University , Humans , Pandemics , Retinal Detachment/diagnosis , Retinal Detachment/epidemiology , Retinal Detachment/therapy , Retrospective Studies , SARS-CoV-2 , Treatment Outcome , Vitrectomy
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