Zhang Ye, Fan Su Jie, Pan Xiao Jing, Zhang Zhi Hong, Ge Qing Shu, Wang Jin, Wang Yue, He Ming Guang, Wang Ning Li
Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Handan City Eye Hospital, Handan, China.
Heliyon. 2024 Jul 4;10(13):e34090. doi: 10.1016/j.heliyon.2024.e34090. eCollection 2024 Jul 15.
During the new coronavirus disease 2019 (COVID-19) outbreak period, there was increasing presentation in the number of patients with acute primary angle closure (APAC). This study aimed to report the occurrence of APAC during the COVID-19 post-restriction period and investigate the related characteristics of these patients with APAC.
This retrospective, multi-center study included consecutive patients seeking APAC treatment at two eye centers in China from December 7, 2022 to January 13, 2023 (post-restriction period) and from December 7, 2021 to January 13, 2022 (control period). Electronic medical records were reviewed, and ocular data of the affected eye(s) were analyzed for patients with unilateral or bilateral APAC. Information including COVID-19 related symptoms, medications used for COVID-19 infection, and living habits and emotions related to the COVID-19 outbreak during the post restriction period were collected using a questionnaire.
Overall, 189 (219 APAC eyes) and 51 (54 APAC eyes) patients with APAC were identified during the post-restriction and control periods, respectively. The patients identified during the post-restriction period were younger ( = 0.043) and had a longer duration from symptoms to treatment ( = 0.039), shorter axial length ( = 0.002), larger pupil diameter ( = 0.004), larger vertical cup disc ratio ( = 0.004), poorer mean deviation values ( = 0.003), and more glaucomatous optic neuropathy diagnoses ( = 0.032) compared with the patients with APAC identified during the control period. Among 151 included patients with APAC who completed the questionnaires, 130 patients with APAC were diagnosed with concurrent COVID-19 infection, of which 54 (41.5 %) had coughing and/or vomiting as the main symptoms. Of these, 89.2 % spent 0 h per day on outdoor activity; 44.6 % drank more water than usual, with 14.6 % drinking more than twice the amount of water than usual; 91.5 % used antipyretics; and 20.0 % had mood swings, including anxiety, depression, and tension, during the concurrent COVID-19 infection.
In our study, a significant increase in the number of patients presenting with APAC with certain characteristics was observed during the COVID-19 post-restriction period. And whether COVID-19 symptoms, such as coughing and vomiting, and behavioral and psychological changes caused by COVID-19 infection contributing to the concurrence of APAC and COVID-19 recurrence require further investigation.
在2019年新型冠状病毒病（COVID-19）疫情暴发期间，急性原发性闭角型青光眼（APAC）患者数量不断增加。本研究旨在报告COVID-19疫情管控解除后APAC的发生情况，并调查这些APAC患者的相关特征。
这项回顾性多中心研究纳入了2022年12月7日至2023年1月13日（疫情管控解除后时期）以及2021年12月7日至2022年1月13日（对照时期）在中国两家眼科中心寻求APAC治疗的连续患者。查阅电子病历，分析单侧或双侧APAC患者患眼的眼部数据。使用问卷收集疫情管控解除后时期与COVID-19相关的症状、用于COVID-19感染的药物以及与COVID-19疫情相关的生活习惯和情绪等信息。
总体而言，在疫情管控解除后时期和对照时期分别确定了189例（219只APAC患眼）和51例（54只APAC患眼）APAC患者。与对照时期确定的APAC患者相比，疫情管控解除后时期确定的患者更年轻（P = 0.043），症状出现至治疗的时间更长（P = 0.039），眼轴长度较短（P = 0.002），瞳孔直径较大（P = 0.004），垂直杯盘比更大（P = 0.004），平均偏差值更差（P = 0.003），青光眼性视神经病变诊断更多（P = 0.032）。在151例完成问卷的纳入APAC患者中，130例APAC患者被诊断为合并COVID-19感染，其中54例（41.5%）以咳嗽和/或呕吐为主要症状。其中，89.2%的患者每天户外活动时间为0小时；44.6%的患者饮水量比平时多，14.6%的患者饮水量比平时多两倍以上；91.5%的患者使用了退烧药；20.0%的患者在合并COVID-19感染期间出现情绪波动，包括焦虑、抑郁和紧张。
在我们的研究中，观察到COVID-19疫情管控解除后时期出现APAC且具有某些特征的患者数量显著增加。以及COVID-19症状，如咳嗽和呕吐，以及COVID-19感染引起的行为和心理变化是否导致APAC与COVID-19复发同时发生，需要进一步研究。
