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This study aimed to describe the impact of the COVID-19 pandemic on the presentation characteristics, timings, and surgical decisions for primary rhegmatogenous retinal detachment (RRD). The cohort included all patients who presented to a Portuguese centre over a two-year period, and these were divided into two groups: pre-COVID and COVID group. The onset of the COVID-19 pandemic was recorded as starting on March 18 2020, the same day the first pandemic-related lockdown came into effect in Portugal. This study enrolled 449 eyes of 443 patients: 272 in the pre-COVID group and 177 in the COVID one. Of the patients, 63.6% were male. The mean ± SD age was 63.0 ±13.2 years (range 13-92 years). The majority of eyes (59.0%, n = 259) were phakic. Further, 55.5% (n = 151) of eyes presented with macular detachment in the pre-COVID group compared with 67% (n = 118) in the COVID group (odds ratio [OR] 1.62; 95% confidence interval [CI]: 1.09-3.86; p = 0.016). Sub analysis of macular status according to age 50 years as the cut off, showed that in the control year, no differences were found. However, there was a higher incidence of macular detachment in older patients, in the COVID era (OR 0.43, 95% CI: 0.19-1.00, p = 0.050). The time from symptom onset to hospital presentation was longer in the COVID era (p = 0.021). Also, the time from hospital presentation to surgery was longer during the pandemic year (p < 0.001). A sub analysis of the patients that were not submitted to surgery on the presentation day (n = 263) revealed a higher waiting time until surgery in the COVID year (median [IQR]: two [1-3] versus three [2-4.5] days, p < 0.001. In the COVID period, silicone oil (OR 2.03, 95% CI: 1.09-3.79, p = 0.025) and C3F8 gas (OR 2.42, 95% CI: 1.57-3.71, p < 0.001) were used more often, which can be taken as surrogate of the increased severity of the cases during the pandemic. No differences in anatomical success or final visual acuity were found between the two groups at three months follow-up. Limitations: retrospective nature; PVR, an important aspect of the RRD disease spectrum and was not assessed; short follow-up.

The impact of COVID-19 pandemic on surgical primary retinal detachments.
Ferreira A, Afonso M, Silva N, Meirelles A.
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Sofia Rokerya

MBBS MRCOphth FRCSI, King's College University Hospital, UK.

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