Neuro-ophthalmology and Emergency department, Hôpital Fondation Rothschild, Paris, France.
Neuro-ophthalmology and Emergency department, Hôpital Fondation Rothschild, Paris, France.
J Fr Ophtalmol. 2022 Jan;45(1):1-8. doi: 10.1016/j.jfo.2021.10.002. Epub 2021 Nov 22.
In March 2020, the sudden rise in the number of SARS-CoV-2 infections in France led the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED).
Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period).
The number of consultations was reduced by more than 50% during the lockdown period (n=2909 patients) and by 30% during the post-lockdown period (n=2622) when compared to periods 1 (n=7125) and 2 (n=8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P=0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P<0.001). These results were likely related to a delay in follow-up consultations due to the lockdown measures.
The reduction in the number of consultations in our OED during the lockdown period affected both minor emergencies and severe ophthalmic diseases, but with no significant delay in diagnosis. More longitudinal and longer study is needed to confirm this and to retrospectively analyze the effects of the COVID-19 outbreak and lockdown.
2020 年 3 月，法国 SARS-CoV-2 感染人数的突然增加导致政府实施了严格的封锁措施，在此期间所有非紧急医疗咨询都被推迟。从 2020 年 3 月 17 日至 5 月 10 日，私人医疗机构关闭，并鼓励远程医疗。眼科护理受到了巨大影响，超过 90%的预约咨询被取消。本研究的目的是描述巴黎严格封锁期间的咨询情况，并分析其对在眼科急诊部（OED）就诊的患者的视觉结果的影响。
分析了在法国巴黎 A. de Rothschild 基金会医院（RFH）眼科急诊部就诊的患者在封锁期间及其后续期间的数据。结果与 2018 年和 2019 年同期进行了比较。将这四个时间段按时间顺序编号：2018 年 3 月 17 日至 5 月 10 日（第 1 期）；2019 年 3 月 17 日至 5 月 10 日（第 2 期）；2020 年 3 月 17 日至 5 月 10 日（第 3 期，封锁期）；2020 年 5 月 11 日至 6 月 9 日（第 4 期，封锁后）。
与第 1 期（n=7125）和第 2 期（n=8058）相比，封锁期间（n=2909 例）和封锁后（n=2622 例）的咨询次数减少了 50%以上。尽管第 4 期 LP4 的就诊人数有所增加，但严重疾病的发病率并没有增加（第 3 期 LP3 为 12.8%，第 4 期 LP4 为 11.1%），入院率也没有统计学差异（第 4.3%比第 3.6%）。神经眼科疾病在第 3 期和第 4 期 LP4 中最为常见。第 4 期 LP4 中新生血管性青光眼的发病率是第 4 期 LP4 的两倍（P=0.08）。我们注意到在第 4 期 LP4 期间，我们的 OED 中接受移植物排斥咨询的患者显著增加（P<0.001）。这些结果可能与封锁措施导致的随访咨询延迟有关。
封锁期间我们的 OED 咨询次数减少，既影响了轻微急症，也影响了严重的眼部疾病，但诊断没有明显延迟。需要进行更多的纵向和更长时间的研究来证实这一点，并回顾性分析 COVID-19 爆发和封锁的影响。
