Power Barry, Donnelly Aaron, Murphy Conor, Fulcher Timothy, Power William
Royal Victoria Eye and Ear, Dublin, Ireland.
Mater Misericordiae University Hospital, Dublin, Ireland.
J Ophthalmol. 2021 Jun 8;2021:5514055. doi: 10.1155/2021/5514055. eCollection 2021.
To compare presentation of infectious keratitis during COVID-19 lockdown with previous years, assess relative severity, and compare outcomes between COVID-19 and pre-COVID-19 era groups.
Acute presentations of infectious keratitis during a strict government-mandated COVID-19 lockdown period were analysed retrospectively (March-May 2020). Data were compared with the same periods in 2018-2019. The clinical notes of patients undergoing corneal scrapes were reviewed, and data were collected on treatment, culture growth, surgical interventions, visual outcomes, admission rates, and risk factors.
There were 37% fewer presentations of infectious keratitis to the ED in 2020 ( = 29, 47, and 45, respectively). Risk factor profiles and microbial data were similar across all periods. Admission rates and use of fortified antibiotics were lower in 2020. COVID-19 era cases recovered less vision (LogMAR 0.26, 0.67, and 0.45, respectively; = 0.04) and were more likely to require surgical intervention (10%, 4%, and 2%, respectively; OR 3.4 (CI 0.7-17.9, = 0.1)).
A concerning fall in presentations of infectious keratitis to ED during the pandemic lockdown was observed. Though societal behaviour changed during the lockdown, our data suggest it is unlikely that the incidence of infectious keratitis fell significantly. It is unclear how and where these patients were treated. We postulate that lower levels of visual recovery and higher rates of surgical intervention may have been caused by delays in accessing care. To minimise avoidable ocular morbidity as COVID-19 resurges, we must communicate clearly with patients and health professionals on how to access available emergency eye care services.
比较新冠疫情封锁期间感染性角膜炎的表现与前几年的情况，评估相对严重程度，并比较新冠疫情时代组和新冠疫情前时代组的治疗结果。
对政府强制实施的严格新冠疫情封锁期间（2020年3月至5月）感染性角膜炎的急性病例进行回顾性分析。将数据与2018 - 2019年同期进行比较。回顾接受角膜刮片检查患者的临床记录，并收集有关治疗、培养结果、手术干预、视力预后、入院率和危险因素的数据。
2020年急诊科感染性角膜炎就诊病例减少了37%（分别为29例、47例和45例）。各时期的危险因素概况和微生物数据相似。2020年入院率和强化抗生素的使用较低。新冠疫情时代的病例视力恢复较差（LogMAR分别为0.26、0.67和0.45；P = 0.04），且更有可能需要手术干预（分别为10%、4%和2%；OR 3.4（CI 0.7 - 17.9，P = 0.1））。
在疫情封锁期间，观察到急诊科感染性角膜炎就诊病例令人担忧地减少。尽管封锁期间社会行为发生了变化，但我们的数据表明感染性角膜炎的发病率不太可能显著下降。不清楚这些患者是如何以及在哪里接受治疗的。我们推测视力恢复水平较低和手术干预率较高可能是由于获得治疗的延迟所致。为了在新冠疫情再次出现时尽量减少可避免的眼部发病率，我们必须就如何获得现有的紧急眼保健服务与患者和卫生专业人员进行清晰的沟通。
