Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, No1. Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
BMC Ophthalmol. 2021 May 15;21(1):215. doi: 10.1186/s12886-021-01985-5.
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.
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.
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.
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.
COVID-19 大流行对医院和患者产生了重大影响。14 天的隔离导致了孔源性视网膜脱离（RRD）手术的推迟。我们旨在探讨在 COVID-19 顶级应急响应期间手术被推迟的一组患者中 RRD 进展的危险因素。
回顾性病例系列研究。回顾性分析 2020 年 2 月 16 日至 4 月 30 日期间在北京同仁医院视网膜科接受手术治疗的所有连续诊断为 RRD 的患者的病历。记录 RRD 进展的病史、症状和临床体征。RRD 进展定义为在隔离期间出现脉络膜脱离或增殖性玻璃体视网膜病变（PVR）进展。使用 Cox 比例风险模型、生存分析和逻辑回归分析危险因素。
79 名患者的 79 只眼符合纳入标准并纳入研究。从患者就诊到手术入院的中位时间为 14 天（3-61 天）。有 70 例（88.6%）患者在发病后 1 周内未到医院就诊。就诊时 69 例（87.3%）为黄斑脱离，27 例（34.2%）合并脉络膜脱离。有 49 例（62.0%）患者为 PVR B，22 例（27.8%）患者为 PVR C，4 例（5.1%）患者为 PVR D，4 例（5.1%）患者为前 PVR。14 天隔离后，21 例（26.6%）患者出现 RRD 进展，9 例患者在手术时出现 RRD 消退。RRD 进展患者和未进展患者的发病时间（p=0.46）和就诊至入院时间（p=0.31）均无显著差异。脉络膜脱离（3.07，1.68-5.60，p<0.001）和赤道后视网膜裂孔（3.79，1.21-11.80，p=0.02）的组合是 RRD 进展的相关因素。
在我们的 COVID-19 疫情研究中，RRD 进展的危险因素包括脉络膜脱离和赤道后视网膜裂孔。眼科医生应尽快为有这些特征的 RRD 患者安排手术。
