Ophthalmic Department Research Articles

Prevalence and significance of fovea plana in patients with epiretinal membrane.

Fovea plana is indicative of an immature inner retina, yet its association with epimacular membrane (ERM) remains unexplored. This study aims to investigate the prevalence of fovea plana in the contralateral eye of patients diagnosed with ERM. A retrospective analysis was conducted on consecutive patients in a monocentric tertiary ophthalmic department between January and April 2021. The study included all patients referred for ERM, with dense optical coherence tomography (OCT) B-scans utilized to assess the incidence of fovea plana in the contralateral eye. Patients with bilateral ERM were excluded from the analysis. Out of 181 patients, 26 exhibited fovea plana in the contralateral eye, resulting in an incidence rate of 14.3%. Demographic characteristics, OCT patterns, and indications for surgery did not differ significantly between patients with and without fovea plana. The prevalence of fovea plana in patients with ERM did not exhibit a statistically significant increase compared to the reported incidence in patients undergoing preoperative cataract surgery. In our cohort, the incidence of fovea plana in patients with ERM was determined to be 14.3%.

Awareness of glaucoma among adult patients attending hawassa university comprehensive specialized hospital ophthalmic outpatient department, Sidama, Ethiopia, August 2022

BackgroundDue to the asymptomatic nature of the disease and lack of awareness, most glaucoma patients present for eye examination late, after significant damage of optic nerve occur. Being aware of glaucoma is important for timely diagnosis of the disease and preventing blindness from it.ObjectiveThe aim of this study was to assess glaucoma awareness and associated factors among adult patients aged 35 and over attending the eye outpatient department.MethodsHospital based cross-sectional study was conducted on 284 adult patients aged 35 and over attending ophthalmic outpatient department from July to August 2022 using systematic random sampling. An interviewer-administered questionnaire was used to collect data. The data were checked for completeness, and then entered to SPSS version 22 software. Descriptive and binary logistic regression analyses were performed. Independent variables with p-value ≤ 0.05 in multivariate logistic regression were considered as statistically significant.ResultsAbout 284 study participants, of whom 57.75% were male, participated in this study with a response rate of 94.1%. The mean age of the study participants was 53.58 years. Only 39.09%(95% CI: 36.53–41.65) were aware of glaucoma. Age groups 46–50 [AOR; 1.83: 1.18, 2.56] and 51–64 [AOR; 3.21: 2.03, 4.39], having college education or above [AOR; 3.1: 2.20, 6.64], family member with glaucoma [AOR; 5.86:3.25, 8.0], income 6500 ETB [AOR; 2.9: 1.97, 5.00] and previous eye examination [AOR; 2.15: 1.46, 4.05] were factors significantly associated with awareness of glaucoma. The main sources of information were news media, family members with glaucoma and health workers.ConclusionMore than half (60.91%) of adult ophthalmic patients attending HUCSH were unaware of glaucoma and need eye health education concerning glaucoma.

Management of a Large and Strange Intraocular Foreign Body: Case Report

Introduction: Intraocular foreign bodies (IOFBs) are unusual and can cause serious eye damage. Case Presentation: We present a case report of a 62-year-old male patient who presented to our ophthalmic emergency department with an intraocular foreign body following a domestic accident.Imaging evaluation with facial CT scan confirmed the presence of a foreign body, made of glass, without any associated bone fractures. Conclusion: Previous studies have emphasized the potential complications and visual consequences associated with these injuries.This case report contributes to the existing literature on intraocular foreign bodies and reinforces the importance of prompt diagnosis and appropriate management.

Abducens Nerve Palsy Caused by Cavernous Sinus Meningioma Mimicking Tolosa-Hunt Syndrome

Purpose: To report a case of abducens nerve palsy caused by cavernous sinus meningioma mimicking Tolosa-Hunt syndrome (THS).Case summary: A 59-year-female visited to the ophthalmic department for sudden onset of horizontal diplopia for 20 days. The extraocular examination showed 10 prism diopters (PD) esotropia at distant fixation and ortho at near fixation without definitive abduction limitation. At 2 months of follow-up, she showed the 25 PD left esotropia with abduction limitation of the left eye. The ocular pain and headache were newly developed. Magnetic resonance imaging (MRI) with contrast was performed and revealed the enlargement and enhancement of left cavernous sinus. THS was suspected and high dose steroid treatment was performed. The ocular findings and headache were improved after treatment. These symptoms showed waxing and waning with steroid tapering during follow-up. The follow-up MRI showed no definitive improvement of cavernous sinus lesion compared with previous study. The cavernous sinus meningioma was considered. There was no improvement of ocular motility findings during follow-up and the strabismus surgery was performed.Conclusions: The abducens nerve palsy with headache can occur caused by cavernous sinus meningioma. It may be difficult to differentiate it from THS in certain cases.

The Beginnings of the Development of Ophthalmology in Slovakia Region Bratislava

The first hospital was founded in Bratislava in the territory of today’s Slovakia, but probably also in the whole of Hungary, already in 1307. One of the very serious disease states, threatening the eyes with blindness, was an infectious eye disease – trachoma. According to preserved historical sources, the large spread of trachoma in the territory of Slovakia occurred during the Turkish wars. A fundamental and extremely important moment for ophthalmology was the construction and opening of the new landscape “State” Hospital in Bratislava in the years 1857-1864 (still within Austria-Hungary). The landscape “State” Hospital was built and equipped very modernly for the given period. The fact that among its first “founding” departments: internal, skin-genital, surgical-obstetrical, psychiatric was also ophthalmic department is extremely important, because this made Bratislava one of the first cities in Europe to have a separate inpatient unit for the treatment of eye diseases. Dr. Kanka in 1882-1892 was also the director of the landscape “State” Hospital, as a royal councilor in Bratislava, he also served as regional ophthalmologist and was awarded the 3rd degree of the Iron Crown. Scientifically he dealt with the problems of accommodation of the eye, operating instruments and eye operations, the effect of poisonous substances on the eyes, but also general problems of health care in Bratislava and in some counties of Hungary. Dr. Kanka was among the doctors who were also very active in publishing. The landscape “State” Hospital in Bratislava, which at the time of its foundation was the largest not only in Upper Hungary, but in Hungary as a whole, became, together with the activities of the “Medical and Natural Science Society” in Bratislava, a center of intensive medical-professional and scientific life.

A machine learning system to optimise triage in an adult ophthalmic emergency department: a model development and validation study

A substantial proportion of attendances to ophthalmic emergency departments are for non-urgent presentations. We developed and evaluated a machine learning system (DemDx Ophthalmology Triage System: DOTS) to optimise triage, with the aim of reducing inappropriate emergency attendances and streamlining case referral when necessary. DOTS was built using retrospective tabular data from 11,315 attendances between July 1st, 2021, to June 15th, 2022at Moorfields Eye Hospital Emergency Department (MEH) in London, UK. Demographic and clinical features were used as inputs and a triage recommendation was given ("see immediately", "see within a week", or "see electively"). DOTS was validated temporally and compared with triage nurses' performance (1269 attendances at MEH) and validated externally (761 attendances at the Federal University of Minas Gerais - UFMG, Brazil). It was also tested for biases and robustness to variations in disease incidences. All attendances from patients aged at least 18 years with at least one confirmed diagnosis were included in the study. For identifying ophthalmic emergency attendances, on temporal validation, DOTS had a sensitivity of 94.5% [95% CI 92.3-96.1] and a specificity of 42.4% [38.8-46.1]. For comparison within the same dataset, triage nurses had a sensitivity of 96.4% [94.5-97.7] and a specificity of 25.1% [22.0-28.5]. On external validation at UFMG, DOTS had a sensitivity of 95.2% [92.5-97.0] and a specificity of 32.2% [27.4-37.0]. In simulated scenarios with varying disease incidences, the sensitivity was ≥92.2% and the specificity was ≥36.8%. No differences in sensitivity were found in subgroups of index of multiple deprivation, but the specificity was higher for Q2 when compared to Q4 (Q4 is less deprived than Q2). At MEH, DOTS had similar sensitivity to triage nurses in determining attendance priority; however, with a specificity of 17.3% higher, DOTS resulted in lower rates of patients triaged to be seen immediately at emergency. DOTS showed consistent performance in temporal and external validation, in social-demographic subgroups and was robust to varying relative disease incidences. Further trials are necessary to validate these findings. This system will be prospectively evaluated, considering human-computer interaction, in a clinical trial. The Artificial Intelligence in Health and Care Award (AI_AWARD01671) of the NHS AI Lab under National Institute for Health and Care Research (NIHR) and the Accelerated Access Collaborative (AAC).

1260. A Retrospective Observational Study on Assessing the Use of Antibiotic Prophylaxis for Outpatients in the Dental and Ophthalmic Department in a Tertiary Care Hospital

Abstract Background Antibiotics are most commonly used in outpatient setting when compared to inpatient setting. Inappropriate antibiotics prescribing in dental and ophthalmic outpatient setting without following any proper guidelines has been identified as a potential driver for antimicrobial resistance especially in the developing world. As there is no sufficient data in India regarding efficient prophylactic use of antibiotics in dental and ophthalmic department, this study is aimed to address this by assessing the antibiotic prophylaxis among outpatients. Methods This retrospective observational study was conducted in the Dental and Ophthalmic outpatient’s department in a tertiary care hospital in South India for 3 months from April 2022 to June 2022. The data regarding the Antibiotic prophylaxis were collected from records of the patients’ prescription and analyzed using simple statistics. Results A total of 395 prescriptions are collected. Mean age was found to be 53.5 years. The key findings are summarized in Table 1 below. Conclusion 85% of patients were prescribed with antibiotics in Dental OP whereas 90% of patients were prescribed with antibiotics in Ophthalmic OP in which 56% of patients were found to have inappropriate duration of Antibiotic therapy. Understanding the current patterns of antibiotic prophylaxis in outpatient setting is necessary to implement antibiotic stewardship and large multicentric studies in the future will help to reduce unnecessary antibiotic use in the developing world. Disclosures All Authors: No reported disclosures

Study of the Efficacy of Indocyanine Green Enhanced Transpupillary Thermotherapy as a Treatment Modality for Retinoblastoma

Background Retinoblastoma represents approximately 4% of all pediatric malignancies and is the most common ocular malignancy in children. It has one of the highest survival rates among all pediatric malignancies owing to improving treatment methods over the years. Objectives The purpose of our work was to evaluate the efficacy of intravenous indocyanine green dye injection combined with diode laser transpupillary thermotherapy (TTT) as a treatment modality for Group (B) intraocular retinoblastoma compared to the standard protocol of treatment. Patients and Methods A prospective interventional comparative study was conducted in the Ocular Oncology Clinic, Ophthalmic Department, Ain Shams University Hospital in the period from August 2017 to December 2020. The study was conducted on twenty tumors, classified as Group (B) retinoblastoma according to International Classification of Intraocular Retinoblastoma (ICRB). It includes; Tumors >3 mm (in basal dimension or thickness), tumors located in the macula (≤3 mm to foveola), juxta-papillary tumors (≤1.5 mm to disc) or tumors surrounded by subretinal fluid (≤5 mm from the tumor margin). They were divided into two main groups: Group I: It included ten (10) tumors; newly diagnosed or recurrent. This group was treated with systemic chemotherapy plus ICG enhanced diode laser TTT, Group II (control group): It included ten (10) tumors; newly diagnosed or recurrent. This group was treated with systemic chemotherapy plus conventional diode laser TTT. Results The study found that ICG has significantly improved uptake of diode laser, eliminating the need for increasing the laser power to the photocoagulation levels which would disrupt the inner retinal layers. ICG-TTT allowed rapid tumor regression and decreased the number of laser sessions needed to achieve tumor regression.ICG-TTT was successful with 3 challenging recurrent masses on a hypopigmented scar and achieved complete regression. There was no statistically significant difference between the two groups as regards the disease-free survival curves using Kaplan Meier analysis. During the period of post chemotherapy follow up, 3 tumors in Group I (30%) and 2 tumors in group II (20%) developed recurrence. And one case in group I (10%) developed a new mass in a remote site. Conclusion The study concluded that ICG-TTT is both efficient and safe despite some potential complications.

Explantation of a sutureless scleral fixated Carlevale intraocular lens due to calcification: a clinical and laboratory report

BackgroundHydrophilic intraocular lens opacification is a rare complication due to calcification. With current new surgical techniques, including lamellar endothelial keratoplasty and vitrectomies, this irreversible complication is becoming more common. In this case study, we present clinical and laboratory features of a case of Carlevale hydrophilic acrylic IOL calcification.Case presentationObservational case report of a single incident case. An 83-year-old man was referred to our ophthalmic department complaining of right eye vision blurring for six months. Slit-lamp biomicroscopy revealed IOL opacification. Deposits of calcium phosphate were found both on the IOL’s surface and inside it, according to thorough investigation using optical, scanning electron microscopy (SEM), and energy-dispersive X-ray (EDX) spectrometry.ConclusionsTo the best of our knowledge, this is the first case to describe the laboratory evidence of Carlevale hydrophilic IOL calcification, suggesting possible explanation mechanisms based on underlying pathology and surgical technique. It reminds us that these findings suggest that physicians should be aware of possible hydrophilic IOL calcification.

Work related eye injuries: Epidemiology in a tertiary care eye hospital of South India

Background: Work related eye injuries are one of the common causes for preventable vision loss. The aim of the study was to analyse the epidemiological characteristics of work related eye injury in a tertiary care eye hospital in South India. Methodology: This prospective observational study included all patients who reported to ophthalmic outpatient department with work related eye injury during the study period. Results: Out of the 416 patients, majority were males. The injuries were common in younger age group. Metal welding and grinding, and agriculture were the high risk occupations for work related eye injuries. Corneal foreign body was the most common type of eye injury noted. Most of the patients were not using protective eye gear at the time of injury. About 7.2% of the patients had previous history of eye injury at work place. Conclusion: As work related eye injury is common in younger age group early intervention is required in order to avoid permanent visual impairment. Specific interventional programmes should be considered as these workers are prone for recurrent eye injuries. There is a need for more effective preventive measures, especially in metal work, agriculture and carpentry, where increased frequency and worst prognoses of injuries were observed.

Cornea opacity, uveitis with iris atrophy and lens damage following cosmetic high-intensity ultrasound of the eyelid: a case report

BackgroundHigh-intensity focused ultrasound (HIFU) is a cosmetic procedure that aims to tone the skin through thermal collagen coagulation. The energy is delivered in the deep layers of the skin, and because of these characteristics, the risks of severe damage to adjacent tissue and the ocular surface may be underestimated. Previous reports have demonstrated superficial corneal opacities, cataracts, increased intraocular pressure, or ocular refractive changes in different patients following HIFU. In this case, we report deep stromal opacities associated with anterior uveitis, iris atrophy and lens opacity formation following a single HIFU superior eyelid application.Case presentationA 47-year-old female presented to the ophthalmic emergency department complaining of pain, hyperemia and photophobia in the right eye following a HIFU application to the superior right eyelid. A slit lamp examination showed three temporal-inferior corneal infiltrates with edema and severe anterior uveitis. The patient was treated with topical corticosteroids, and six months later, there was residual corneal opacity, iris atrophy and peripherical cataract formation. No surgical procedure was needed, and the final vision was Snellen 20/20 (1.0).ConclusionThe risk of severe impairment to the ocular surface and ocular tissues may be underestimated. Cosmetic surgeons and ophthalmologists must be aware of the complications, and the long-term follow-up of these changes needs further investigation and discussion. Safety protocols of the HIFU intensity threshold for thermal lesions in the eye and the use of protective eye devices should be better evaluated.

The surge of acute angle-closure glaucoma during the outbreak of Omicron in a tertiary hospital in Shanghai.

Since December 2022, China has eliminated the compulsory nucleic acid screening, which led to a new pandemic of Omicron. We observed a surge of primary angle-closure glaucoma (PACG) at a largest tertiary hospital in Shanghai. We evaluated the potential relationship between the infection of Omicron and the occurrence of PACG. In this retrospective cross-sectional study, we identified 41 patients diagnosed with PACG from 523 individuals registered in ophthalmic emergency from December 2022 to January 2023. We compared the proportion of PACG patients in all the patients registered at the ophthalmic emergency department in the corresponding period (December and January) from 2018 to 2023. The proportion of PACG patients rose to 6.74% and 9.13%, nearly a five-fold increase compared to the previous 1.90%. The proportion of PACG patients throughout 2022 also increased in the recent 2 months. All PACG patients in our center from Dec. 21st 2022 to Jan. 27th 2023 had positive nucleic acid tests at their initial visits. The peak of glaucoma came around Dec. 27th 2022, while the peak of the internal medicine emergency came around Jan. 5th 2023. The behavior pattern of the infected people and anxiety mood would induce the PACG attack. Some ophthalmic advice should be added to the Chinese treatment guidelines for COVID-19. Also, a shallow anterior chamber and narrow angle need to be ruled out when necessary. Further studies on larger populations are needed to explore the relationship between PACG and Covid.

Prise en charge des diplopies binoculaires aux urgences ophtalmologiques du Centre hospitalier régional universitaire de Tours

To describe the etiologies of binocular diplopia for patients presenting to the ophthalmologic emergency department of the Regional University Center Hospital (CHRU) of Tours. This is a retrospective study of the medical records of patients who presented with binocular diplopia in the ophthalmic emergency department of the CHRU of Tours between January 1st and December 31st, 2019. Binocular diplopia was classified as paralytic or non-paralytic according to the ocular motility examination. One hundred twelve patients were included. The median age was 61 years. Internal referral from other hospital services represented 44.6% of the patients. On ophthalmological examination, 73.2% had paralytic diplopia, 13.4% non-paralytic diplopia and 13.4% normal examination. Neuroimaging was performed in 88.3% of cases, with 75.7% of patients receiving it on the same day. Oculomotor nerve palsy was the most frequent cause of diplopia in 58.9%, the majority represented by abducens nerve palsy (60.6%). The most frequent etiology of binocular diplopia was ischemic, with microvascular damage in 26.8% of cases and stroke in 10.7% of cases. Among patients assessed in an ophthalmological emergency department setting, one in ten patients had stroke. It is essential to inform patients of the urgent nature of ophthalmological evaluation in the case of acute binocular diplopia. Urgent neurovascular management is also mandatory and should be based on the clinical description provided by the ophthalmologist. Neuroimaging should be performed as soon as possible, based on the ophthalmologic and neurological findings.

The evolution of women ophthalmologists in India.

The evolution of women ophthalmologists in India.

A Pilot Investigation Evaluating Relative Changes in Fronto-Occipital Alpha and Beta Spectral Power as Measurement of Anesthesia Hypnotic Depth.

Other than clinical observation of a patient's vegetative response to nociception, monitoring the hypnotic component of general anesthesia (GA) and unconsciousness relies on electroencephalography (EEG)-based indices. These indices exclusively based on frontal EEG activity neglect an important observation. One of the main hallmarks of transitions from wakefulness to GA is a shift in alpha oscillations (7.5-12.5 Hz activity) from occipital brain regions toward anterior brain regions ("alpha anteriorization"). Monitoring the degree of this alpha anteriorization may help to guide induction and maintenance of hypnotic depth and prevent intraoperative awareness. However, the occipital region of the brain is completely disregarded and occipital alpha as characteristic of wakefulness and its posterior-to-anterior shift during induction are missed. Here, we propose an application of Narcotrend's reduced power alpha beta (RPAB) index, originally developed to monitor differences in hemispheric perfusion, for determining the ratio of alpha and beta activity in the anterior-posterior axis. Perioperative EEG data of 32 patients undergoing GA in the ophthalmic surgery department of Bern University Hospital were retrospectively analyzed. EEG was recorded with the Narcotrend® monitor using a frontal (Fp1-Fp2) and a posterior (T9-Oz) bipolar derivation with reference electrode over A2. The RPAB index was computed between both bipolar signals, defining the fronto-occipital RPAB (FO-RPAB). FO-RPAB was analyzed during wakefulness, GA maintenance, and emergence, as well as before and after the intraoperative administration of a ketamine bolus. FO-RPAB was compared with a classical quantitative EEG measure-the spectral edge frequency 95% (SEF-95). A significant shift of the FO-RPAB was observed during both induction of and emergence from GA ( P < .001). Interestingly, the additional administration of ketamine during GA did not lead to a significant change in FO-RPAB ( P = 0.81). In contrast, a significant increase in the SEF-95 in the frontal channel was observed during the 10-minute period after ketamine administration ( P < .001). FO-RPAB appears to qualify as a marker of unconsciousness, reflecting physiological fronto-occipital activity differences during GA. In contrast to frontal SEF-95, it is not disturbed by additional administration of ketamine for analgesia.

Luxation antérieure d’un cristallin clair post-traumatique

We here report the case of a 52-year-old patient admitted to the ophthalmic emergency department with ocular pain and redness following right ocular trauma. Ophthalmologic examination of the right eye revealed impaired near visual acuity of counting fingers, diffuse conjunctival hyperaemia, dislocation of the clear crystalline lens into the anterior chamber in front of the iris with contact with endothelial cells and ocular hypertonia 40 mmHg. Ocular ultrasound was normal. The patient received emergency medical treatment based on both local and general hypotonizing drug. Then phacoemulsification including direct surgical removal of the entire lens associated with anterior vitrectomy were performed. Postoperative outcome was marked by normalization of intraocular pressure and by the absence of optic nerve and corneal endothelial cell damage.

Irreversible visual loss in a tertiary care center in Saudi Arabia

Background Data on visual loss have been collected in various regions of Saudi Arabia. However, we lack data representing a wide range of different populations or reflecting changes since the first study in Saudi Arabia in 1986. Purpose The aim of this study was to determine the causes of uncorrected visual impairment and blindness in the Saudi population as presented by countrywide referrals to King Faisal Specialist Hospital and Research Center (KFSH&RC). Patients and methods This is a prospective descriptive study on all patients of all ages attending the eye clinic in KFSH&RC or referred to the Ophthalmic Consult Service with WHO definitions of visual impairment [visual acuity (VA)=20/60 or visual field (VF) <20°] and blindness (VA=20/400 or VF<10°). Best-corrected visual acuity, age, sex, and causes of visual loss were tabulated. The included patients were divided into five groups: unilateral impairment (UI), bilateral impairment (BI), unilateral blindness (UB), bilateral blindness (BB), and one impaired eye with one blind eye (BIB). Results There were 197 patients attending the ophthalmic department from May until November 2014 with WHO definition of visual impairment or blindness. Bilateral visual loss was reported in 129 (65.48%) patients. Patients from rural areas represented 78.14% of all included patients. UI, BI, UB, BB, and BIB were detected in 32 (16.24%), 56 (28.43%), 36 (18.27%), 36 (18.27%), and 37 (18.78%) patients with visual loss, respectively. Brain tumors, proliferative diabetic retinopathy, incurable myopia with extensive chorioretinal degeneration, and glaucoma were the main causes of visual loss. Conclusion The study contributed to a global database for the different causes of irreversible visual loss in Saudi Arabia. Furthermore, the design and provision of low vision aids and social support can be targeted to appropriately identified subgroups of our population.

Seagull wings appearance on optical coherence tomography: A case of peripapillary detachment in pathologic myopia.

To report the case of a patient who presented with a peripapillary retinal detachment caused by pathological myopia. A 73-year-old female with a clinical history of high myopia was admitted to our ophthalmic department complaining of vision loss in her right eye. Her best-corrected visual acuity was 20/25 in the right eye and 20/400 in the left eye. The refractive error was -9.00 D in both eyes. The anterior segment and pupillary reflex were normal. Dilated fundus examination revealed myopic retinopathy in both eyes and a yellow peripapillary lesion, distinct from the myopic conus and encircling almost the whole optic disc, in her right eye. The left eye displayed macular atrophy with macular pigmentation due to a previous myopic choroidal neovascularization. Optical coherence tomography showed a localized retinal detachment in the peripapillary area, adjacent to the inferior edge of the optic disc, giving a strange "seagull wings" appearance. In case of peripapillary neuroepithelial detachment the presence of PDPM in high myopic patients should always be excluded. Further research is due in order to better understand this clinical entity's pathogenesis and prognosis.

Impact de la pandémie de COVID-19 sur les urgences ophtalmologiques du CHU de Toulouse lors du premier confinement du 17 mars au 10 mai 2020

We conducted this study to assess the impact of the COVID-19 pandemic and the lockdown in France from March 17, 2020 to May 10, 2020, on the ophthalmic emergency department at Toulouse University Hospital, compared to the period from March 2 to March 16, 2020. This was a retrospective observational study, conducted in the ophthalmic emergency department of Toulouse University Hospital. We included the patients presenting to the emergency department from March 2 to May 10, 2020. We recorded age, sex, day of visit, time until care was received, past ocular history, outpatient or inpatient status, final diagnosis and its severity, outpatient or inpatient disposition, and medical or surgical treatment after the emergency department visit. We found a substantial decrease in the number of patients per day, mostly during the first month of the lockdown: 44 patients per day before the lockdown compared to 23 patients per day during the first month, followed by 38 patients per day for the second month of lockdown; more patients visiting promptly; and elderly patients represented a higher proportion of patients. The first lockdown in France due to the COVID-19 pandemic had an impact on the Toulouse ophthalmic emergency department, especially concerning the number of patients per day; this study helps to assess individual behavior in this context of a public health crisis.

Effects of the Implementation of an Emergency Surgical Pattern in Patients with Rhegmatogenous Retinal Detachment: A Retrospective Observational Study.

Background To analyze the effects of the implementation of emergency surgical patterns in patients with rhegmatogenous retinal detachment (RRD) and provide evidence for promoting emergency surgical patterns for RRD. Methods We reviewed the electronic medical records of 346 patients (348 eyes) who underwent surgical repair of RRD at the Zhongshan Ophthalmic Center in Southern China. A total of 140 patients (140 eyes) in the routine inpatient surgery group were collected at the fundus disease department between January 2019 and December 2019, and 206 patients (208 eyes) in the emergency surgery group were collected at the ophthalmic emergency department between January 2021 and December 2021. Demographics, best-corrected visual acuity (BCVA) expressed as the logarithm of the minimum angle of resolution (logMAR), the status of the macula before surgery, time to presentation, treatment interval, and postoperative BCVA measured at least three months follow-up were compared. Results The preoperative BCVA (logMAR) of the emergency surgery group and the inpatient surgery group were 1.0 (0.4–1.7) and 1.4 (0.7–1.7), respectively, with significant differences between groups (P < 0.001). However, patients had a shorter time to presentation (7 days vs. 21 days, P < 0.001), shorter treatment interval (2 days vs. 12 days, P < 0.01), and significantly better postoperative BCVA (logMAR 0.5 vs. logMAR 1.0, P < 0.001) in the emergency surgery group than in the inpatient surgery group. There was no significant difference in primary anatomical success between the two groups (P=0.802). The median follow-up for the emergency surgery group and the inpatient surgery group were 6.08 months and 6.2 months, respectively, with no significant differences (P > 0.05). Conclusions Patients who underwent emergency surgical patterns of RRD had better visual outcomes after surgery than patients with routine inpatient surgery, which might be attributed to a shorter duration, shorter treatment interval, and the preoperative status of the macula in the emergency surgery pattern. Emergency surgical patterns for RRD should be considered to achieve better surgical outcomes in suitable patients.