Clinical Presentation of Rhegmatogenous Retinal Detachment during the COVID-19 Pandemic: A Historical Cohort Study.
Clinical Presentation of Rhegmatogenous Retinal Detachment during the COVID-19 Pandemic: A Historical Cohort Study.
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DOI：
10.1016/j.ophtha.2020.10.009
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发表时间：
2021-05
期刊：
影响因子：
13.7
通讯作者：
Xu D
中科院分区：
文献类型：
--
作者：
Patel LG;Peck T;Starr MR;Ammar MJ;Khan MA;Yonekawa Y;Klufas MA;Regillo CD;Ho AC;Xu D
研究2019冠状病毒病（COVID-19）大流行对急性原发性孔源性视网膜脱离（RRD）临床表现的影响。具有历史对照的单中心、连续病例系列。在COVID-19大流行期间（2020年3月9日至4月27日）的50天期间以及前一年（2019年3月4日至4月22日）在美国相应的50天期间寻求原发性RRD治疗的连续性患者。比较队列以评估人口统计学变量和临床表现。采用多因素logistic回归分析确定黄斑附着状态的预测因素。主要结局是就诊时RRD上有黄斑的患者比例。次要结局包括视力（VA）、症状出现前的持续时间、症状发作1天内寻求治疗的比例以及原发性增生性玻璃体视网膜病变（PVR）的存在。2020年队列纳入82例患者，而2019年主要对照队列纳入111例患者。两组之间的人口统计学因素相似。与2019年队列（55/111例患者[49.5%]; P = 0.001）相比，2020年队列（20/82例患者[24.4%]）中表现出黄斑区RRD的患者显著较少。2020年队列中的患者在就诊时显示出更差的中位VA（2020年最小分辨率角的对数为1.00 [logMAR; Snellen当量，20/200]，2019年为0.48 logMAR [Snellen当量，20/60]; P = 0.008），在出现症状1天内寻求治疗的患者较少（2020年为16/80例患者[19.5%]，2019年为41/106例患者[36.9%]; P = 0.005），更大比例的患者表现为原发性PVR（2020年11/82例患者[13.4%] vs. 2019年5/111例患者[4.5%]; P = 0.03）。在多变量分析中，年龄较小（P = 0.03）和确定的患者状态（P = 0.02）是2020年队列中黄斑状态的独立预测因素。在2020年COVID-19大流行期间，患有原发性RRD的患者患黄斑病变的可能性较低，更有可能延迟寻求治疗，并表现出更差的视力和PVR。
To investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on the clinical presentation of acute, primary rhegmatogenous retinal detachment (RRD). Single-center, consecutive case series with historical controls. Consecutive patients seeking treatment for primary RRD in a 50-day period during the COVID-19 pandemic (March 9–April 27, 2020) and the corresponding 50-day period during the previous year (March 4–April 22, 2019) in the United States. The cohorts were compared to assess demographic variables and clinical presentations. Multivariate logistic regression was used to identify factors predictive of presenting macular attachment status. The primary outcome was the proportion of patients with macula-on RRD at presentation. Secondary outcomes included visual acuity (VA), duration of symptoms before presentation, proportion seeking treatment within 1 day of symptom onset, and presence of primary proliferative vitreoretinopathy (PVR). Eighty-two patients were included in the 2020 cohort compared with 111 patients in the 2019 primary control cohort. Demographic factors were similar between the groups. Significantly fewer patients demonstrated macula-on RRD in the 2020 cohort (20/82 patients [24.4%]) than in the 2019 cohort (55/111 patients [49.5%]; P = 0.001). Patients in the 2020 cohort showed worse median VA at presentation (1.00 logarithm of the minimum angle of resolution [logMAR; Snellen equivalent, 20/200] in 2020 vs. 0.48 logMAR [Snellen equivalent, 20/60] in 2019; P = 0.008), fewer patients sought treatment within 1 day of symptoms (16/80 patients [19.5%] in 2020 vs. 41/106 patients [36.9%] in 2019; P = 0.005), and a greater proportion demonstrated primary PVR (11/82 patients [13.4%] in 2020 vs. 5/111 patients [4.5%] in 2019; P = 0.03). In multivariate analysis, younger age (P = 0.03) and established patient status (P = 0.02) were independent predictors of macula-on status in the 2020 cohort. Patients with primary RRD during the 2020 COVID-19 pandemic were less likely to have macula-on disease and more likely to delay seeking treatment and to show worse vision and PVR.
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影响因子：
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作者：
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DOI：
10.24875/recice.m20000123
发表时间：
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期刊：
REC-INTERVENTIONAL CARDIOLOGY
影响因子：
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