Liu Z T, Chen Z D, Bing Y C, Yang Y F, Zhang Y N, Yang W X, Gao X B, Huang J J, Lin M K, Yu M B
Zhongshan Ophthalmic Center, Sun Yat-sen University, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China.
Zhonghua Yan Ke Za Zhi. 2023 Oct 11;59(10):838-845. doi: 10.3760/cma.j.cn112142-20230330-00129.
To investigate the clinical presentation pattern of acute primary angle-closure glaucoma (PACG) during the 2019 novel coronavirus (2019-nCoV) pandemic over the past three years, and its relationship with 2019-nCoV infections of Omicron variants in Guangdong province. Ecological study.Patients who were newly diagnosed with acute PACG from February 2020 to January 2023 at the Zhongshan Ophthalmic Center of Sun Yat-sen University were included in the study, and their basic information was collected. Patients were divided into the 2020 group (diagnosed between February 1st, 2020 and January 31st 2021), the 2021 group (diagnosed between February 1st, 2021 and January 31st 2022), and the 2022 group (diagnosed between February 1st, 2022 and January 31st 2023). The clinical presentation pattern of newly diagnosed acute PACG was observed and compared between groups. The daily number of newly diagnosed 2019-nCoV infections in Guangdong province was obtained from the Chinese Center for Disease Control and Prevention. The correlation between the daily number of newly diagnosed acute PACG and that of newly diagnosed 2019-nCoV infections during the epidemic period of Omicron variants between December 2022 and January 2023 was assessed. The study included 1 048 patients with newly diagnosed acute PACG, with 235 for the 2020 group, 274 for the 2021 group, and 539 for the 2022 group. Our results showed that the average weekly number of newly diagnosed acute PACG patients in 2022 [8 (5, 11)] was significantly larger than that in 2020 (4.52±1.95, <0.05) and 2021 (5.27±2.76, <0.05). The average weekly number increased to 22.11±20.84 between December 2022 and January 2023. The total number of newly diagnosed acute PACG patients during this period was 199, which was 36.9% (199/539) of the total number of the same year and was 6.63 and 6.42 times as many as that in the same period (December and January) of 2020 and 2021. The proportion of patients with bilateral eye involvement during this period in 2022 was significantly higher than that in 2020 and 2021 (<0.05). Further analysis found that 88.6% (109/123) of cases had a history of 2019-nCoV infection 2 (0, 3) days before the onset of acute PACG symptoms in average. The estimated daily number of acute PACG onset increased rapidly, peaked on December 23th, 2022, and then dropped gradually. This trend was similar to that of the daily number of new 2019-nCoV infections in Guangdong province. Changes of the daily number of new 2019-nCoV infections in Guangdong province had a positive correlation with the estimated daily number of acute PACG onset (=0.84, <0.001). A dramatic increase in the clinical presentation of acute PACG was observed at Zhongshan Ophthalmic Center between December 2022 and January 2023, which was the epidemic period of Omicron variants. There is a correlation between the trend of the estimated daily number of acute PACG onset and that of new 2019-nCoV infections of Omicron variants in Guangdong province, but the exact reason remains to be further studied. (This article was published ahead of print on the official website of Chinese Journal of Ophthalmology on August 31, 2023).
为调查过去三年新型冠状病毒(2019-nCoV)大流行期间急性原发性闭角型青光眼(PACG)的临床表现模式,及其与广东省奥密克戎变异株2019-nCoV感染的关系。生态学研究。纳入2020年2月至2023年1月在中山大学中山眼科中心新诊断为急性PACG的患者,并收集其基本信息。患者分为2020组(2020年2月1日至2021年1月31日诊断)、2021组(2021年2月1日至2022年1月31日诊断)和2022组(2022年2月1日至2023年1月31日诊断)。观察并比较各组新诊断急性PACG的临床表现模式。广东省每日新诊断的2019-nCoV感染病例数来自中国疾病预防控制中心。评估2022年12月至2023年1月奥密克戎变异株流行期间新诊断急性PACG的每日病例数与新诊断2019-nCoV感染的每日病例数之间的相关性。该研究纳入1048例新诊断的急性PACG患者,其中2020组235例,2021组274例,2022组539例。结果显示,2022年新诊断急性PACG患者的平均每周病例数[8(5,11)]显著高于2020年(4.52±1.95,<0.05)和2021年(5.27±2.76,<0.05)。2022年12月至2023年1月平均每周病例数增至22.11±20.84。此期间新诊断急性PACG患者总数为199例,占同年总数的36.9%(199/539),是2020年和2021年同期(12月和1月)的6.63倍和6.42倍。2022年此期间双眼受累患者比例显著高于2020年和2021年(<0.05)。进一步分析发现,88.6%(109/123)的病例在急性PACG症状发作前平均2(0,3)天有2019-nCoV感染史。急性PACG发病的估计每日病例数迅速增加,于2022年12月23日达到峰值,随后逐渐下降。这一趋势与广东省新诊断2019-nCoV感染的每日病例数趋势相似。广东省新诊断2019-nCoV感染的每日病例数变化与急性PACG发病的估计每日病例数呈正相关(=0.84,<0.001)。2022年12月至2023年1月为奥密克戎变异株流行期,中山眼科中心急性PACG的临床表现显著增加。急性PACG发病的估计每日病例数趋势与广东省奥密克戎变异株新诊断2019-nCoV感染的趋势之间存在相关性,但确切原因仍有待进一步研究。(本文于2023年8月31日在中国眼科学杂志官网提前发表)