Decreased retinal detachments during a COVID-19 lockdown period in Colorado.

Editor:

There are emerging reports of lower rates of retinal detachments during the COVID‐19 lockdown periods in multiple countries around the world. The Moorfields Eye Hospital in London first reported a 62% decrease in the number of patients presenting with retinal detachment during their lockdown period compared to the same period in 2019 (Wickham et al. 2020). An ophthalmic emergency department in Bologna, Italy, showed a similar 64% decrease, and a 53% decrease was described per report using the Scottish Retinal Detachment Census (Pelligrini et al. 2020). To our knowledge, there have not been any reports on retinal detachment incidence during the COVID‐19 lockdown in North America so far. We found a 56% decrease in number of retinal detachment surgeries performed and a 50% decrease in retinal tears and holes requiring laser during a COVID‐19 lockdown period in Colorado. Of those detachments that presented this year during lockdown, more presented as macula off (63.6% in 2020 versus 44% in 2019), suggesting a possible trend of delayed presentation to care. See Table 1 for characteristics of retinal detachments and retinal laser procedures in 2020 versus 2019.

Table 1

Total retinal detachment repairs and total retinal tear/holes requiring laser in the COVID‐19 lockdown period at the University of Colorado Sue Anschutz‐Rogers Eye Center from 3/13/2020 to 5/8/2020 as compared with the same time period in 2019.

Characteristics	2019	2020
Total # retinal detachment repairs	25	11
Sex (Female/Male)	9/16	3/8
Mean age ± SD	56.8 ± 16	57.8 ± 8.1
Macula On	14 (56%)	4 (36.4%)
Macula Off	11 (44%)	7 (63.6%)
Total # retinal tear/hole laser procedures	16	8
Sex (Female/Male)	9/7	3/5
Mean age ± SD	61.1 ± 12.9	63.0 ± 14.0

We defined our COVID‐19 “lockdown” period as beginning 13 March 2020 (first COVID‐19 death in Colorado, first mandated shutdown of public venues) and ending 8 May 2020 (mandatory stay‐at‐home order lifted, some businesses allowed to re‐open). We reviewed the charts of all patients undergoing retinal detachment surgery or retinal laser procedures at the University of Colorado Sue Anschutz‐Rodgers Eye Center, a large academic eye centre in Aurora, Colorado, and compared them with those of the same time period in 2019. This study was approved by the Colorado Multiple Institution Review Board (COMIRB), protocol #20‐1207.

These findings of decreased retinal detachment rates in our study and others are concerning, as it may suggest patients were presenting less due to fear of contracting coronavirus or were experiencing difficulties accessing proper channels of care due to closure of general practitioner and optometric offices during the lockdown. One could also suggest that retinal detachments were actually occurring at a decreased rate, potentially due to decreased rates of anterior segment surgery. However, it seems unlikely to see this magnitude of effect this early, since increase in detachment risk occurs in the first year after cataract surgery and not only in the few months following. Future studies are needed to confirm these trends in a larger and multi‐institutional scale, and there is a need to assess the rates of retinal detachments in the months following lockdown periods to see if there is a wave of patients with delayed presentations. Regardless, we must make concerted efforts to increase awareness of retinal detachment warning signs and encourage patients to seek ophthalmic care in any future lockdown periods, which may be looming with a second wave of COVID‐19.