Arjmand Parnian, Murtaza Fahmeeda, Eshtiaghi Arshia, Popovic Marko M, Kertes Peter J, Eng Kenneth T
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Can J Ophthalmol. 2021 Apr;56(2):88-95. doi: 10.1016/j.jcjo.2020.12.008. Epub 2020 Dec 26.
To describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on the characteristics of retinal detachments (RD) at a tertiary centre.
Retrospective consecutive case series.
One hundred and ninety eyes of 188 patients with primary, rhegmatogenous RD.
Patients with RD who presented over a 1-year period (September 14, 2019 to September 13, 2020). The relationship between demographic, anatomic, and visual acuity parameters were compared before and after onset of the pandemic using generalized estimating equations.
Macular status and corrected distance visual acuity on presentation.
One hundred and eighty-seven eyes, divided into 2 cohorts: pre-COVID (n = 100 September 14, 2019 to March 13, 2020) and post-COVID (n = 87, March 14, 2020 to September 13, 2020). Of the eyes, 63.2% (n = 87) presented with macular detachment in the post-COVID group compared with 45% (n = 100) in the pre-COVID group (odds ration [OR], 2.14; 95% confidence interval [CI],1.19-3.86; p = 0.011). As well, eyes in the pre-pandemic cohort had significantly fewer detached quadrants on initial examination (OR, 0.53; 95% CI, 0.30-0.93; p = 0.026). Patients in the post-COVID group had a significantly worse corrected distance visual acuity at baseline (mean difference [MD] = -0.35 logMAR, 95% CI, -0.60 to -0.09; p = 0.008), but not at 1 month or at final follow-up. No differences were seen between groups with respect to demographics, lens status, treatment, time to presentation, or chronicity. Pneumatic retinopexy was the most commonly performed procedure in both cohorts, with a 71.5% success rate.
Closures after the COVID-19 pandemic affected the characteristics of RDs at presentation with respect to macular detachment, extent of RD, and presenting visual acuity. At final follow-up, final visual acuity and anatomic outcomes were similar between the 2 groups. These data are helpful for future patient education, triaging, and treatment decision making.
描述2019年冠状病毒病（COVID-19）大流行对某三级医疗中心视网膜脱离（RD）特征的影响。
回顾性连续病例系列研究。
188例原发性孔源性视网膜脱离患者的190只眼。
选取在1年期间（2019年9月14日至2020年9月13日）就诊的视网膜脱离患者。使用广义估计方程比较大流行开始前后人口统计学、解剖学和视力参数之间的关系。
就诊时的黄斑状态和矫正远视力。
187只眼分为两个队列：COVID前（2019年9月14日至2020年3月13日，n = 100）和COVID后（2020年3月14日至2020年9月13日，n = 87）。在这些眼中，COVID后组有63.2%（n = 87）出现黄斑脱离，而COVID前组为45%（n = 100）（优势比[OR]，2.14；95%置信区间[CI]，1.19 - 3.86；p = 0.011）。此外，大流行前队列的眼在初次检查时脱离象限明显更少（OR，0.53；95% CI，0.30 - 0.93；p = 0.026）。COVID后组患者在基线时的矫正远视力明显更差（平均差值[MD] = -0.35 logMAR，95% CI，-0.60至-0.09；p = 0.008），但在1个月或最终随访时无差异。两组在人口统计学、晶状体状态、治疗、就诊时间或病程方面未见差异。气体视网膜固定术是两个队列中最常施行的手术，成功率为71.5%。
COVID-19大流行后，视网膜脱离在就诊时的特征在黄斑脱离、视网膜脱离范围和就诊视力方面受到影响。在最终随访时，两组的最终视力和解剖学结果相似。这些数据有助于未来的患者教育、分诊和治疗决策。
