AUTHOR=Zhou Li , Wu Shaoqun , Wang Yong , Bao Xianyi , Peng Tingting , Luo Wenjing , Ortega-Usobiaga Julio 

TITLE=Clinical presentation of acute primary angle closure during the COVID-19 epidemic lockdown

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1078237

DOI=10.3389/fmed.2022.1078237

ISSN=2296-858X

ABSTRACT=Purpose: This study aimed to investigate the clinical presentation of acute primary angle closure (APAC) during the coronavirus disease (COVID-19) epidemic lockdown in Wuhan.
Design: This was a single-center, consecutive case series with historical controls. Participants: Consecutive patients seeking APAC treatment at the Aier Eye Hospital of Wuhan University during the 76 days (January 23–April 8, 2020) when the lockdown policy was implemented due to the COVID-19 pandemic were compared to those during the same period the following year (January 23–April 8, 2021), when the lockdown policy was not implemented.
Methods: The cohorts were compared to assess demographic variables and clinical presentations. Multivariate logistic regression was used to determine the predictors of APAC leading to blindness.
Main Outcome Measures: The main outcome was the proportion of blindness caused by APAC. Secondary outcomes included time from symptom to treatment (TST) of APAC, corrected distance visual acuity (CDVA), intraocular pressure (IOP), ocular biometry, pupil diameter (PD), corneal edema, and optic nerve cup:disc (C/D) ratio. Results: In total, 54 patients (64 eyes) were included in the 2020 study cohort, compared with 46 patients (51 eyes) in the 2021 control cohort. Demographic factors were similar between the groups. Significantly more patients developed blindness in the 2020 cohort (14/64 eyes [21.87%]) than in the 2021 cohort (4/51 eyes [7.84%]; P = 0.03). Patients in the 2020 cohort showed a longer TST (241.84 ± 211.95 hours in 2020 vs. 121.53 ± 96.12 hours in 2021; P = 0.001), higher IOP at presentation (52.63 ± 12.45 mmHg in 2020 vs. 45.16 ± 9.79 mmHg in 2021; P = 0.001), larger PD (5.47 ± 1.62 mm in 2020 vs. 4.33 ± 1.27 mm in 2021; P = 0.001), and more glaucomatous optic neuropathy (GON) diagnoses (20/64 eyes [31.25%]) in 2020 vs. 7/51 eyes [13.73%] in 2021; P = 0.03). 
Conclusions: The time between the onset of APAC symptoms and its treatment during the COVID-19 epidemic lockdown was significantly prolonged, resulting in high IOP, mydriasis, and GON, which increased the blindness rate of APAC patients.