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Retinal detachment during COVID-19 era: a review of challenges and solutions
Amirhossein Roshanshad1,2, Susanne Binder3,4
1Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
The COVID-19 pandemic significantly reduced retinal detachment (RD) diagnosis and surgeries, leading to delayed presentations and poorer prognoses. Telemedicine and optimized management guidelines can mitigate these negative impacts.
Area of Science:
- Ophthalmology
- Public Health
- Epidemiology
Background:
- The Coronavirus disease 2019 (COVID-19) pandemic created significant challenges in diagnosing and managing various medical conditions.
- Retinal detachment (RD) presentation and surgical interventions were notably affected during this period.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on retinal detachment (RD) presentation and surgical procedures.
- To propose strategies for minimizing the adverse effects of lockdowns on RD diagnosis and management.
Main Methods:
- A comprehensive literature search was conducted across major scientific databases including PubMed, Embase, Scopus, Web of Science, and Google Scholar.
- Keywords used for the search were "Retinal detachment" combined with "Coronavirus OR COVID-19 OR SARS OR MERS."
Main Results:
- A 53-66% reduction in RD presentation was observed during COVID-19 lockdowns, with indicators of delayed diagnosis such as increased symptom duration and higher rates of proliferative vitreoretinopathy.
- RD repair surgeries decreased by 56-62%, although RD repair became the most frequent ophthalmic surgery in April 2020, shifting from cataract surgery.
- Phacovitrectomy emerged as an efficient alternative to vitrectomy alone, reducing operations, personal protective equipment use by 50%, and costs by 17-20%.
Conclusions:
- Delayed presentation and surgery for RD are linked to worse patient prognoses.
- Optimizing RD management guidelines and implementing robust telemedicine systems are crucial for mitigating the impact of lockdowns on patient outcomes.
Background:
Since the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, there have been obstacles in the proper diagnosis and management of many diseases. We evaluated the changes in retinal detachment (RD) presentation and surgery during the COVID-19 pandemic and propose solutions to minimize the detrimental effects of lockdown on RD diagnosis.
Materials And Methods:
PubMed, Embase, Scopus, Web of Science, and Google Scholar were searched for relevant articles with the keywords "Retinal detachment" AND "Coronavirus OR COVID-19 OR SARS OR MERS."
Results:
The COVID-19 lockdown was associated a 53-66% reduction in RD presentation. The decrease in the rate of macula-on RD, the increase in the mean duration of symptoms, and the rise in the number of patients with proliferative vitreoretinopathy were all suggestive of a delayed presentation of RD. Moreover, a drop of 56-62% in RD repair surgeries was observed. However, the most frequently performed ophthalmic surgery changed from cataract surgery in April 2019 to RD repair in April 2020. Using phacovitrectomy instead of vitrectomy alone can reduce the number of operations in ophthalmology centers, decrease the use of personal protective equipment by 50%, and cut costs per patient by 17-20%. Also, developing a well-organized telemedicine system can decrease unnecessary visits and delayed presentations.
Conclusion:
Delay in RD presentation and surgery is associated with a poorer prognosis. Optimizing the guidelines of RD management and developing a well-organized telemedicine system can minimize the impact of lockdown on RD management.
