OPHTHALMIC PATHOLOGY TREATED DURING COVID-19 AT THE OPHTHALMOLOGY CLINIC OF “SF. SPIRIDON” COUNTY CLINICAL EMERGENCY HOSPITAL IN IAŞI, ROMANIA

https://www.doi.org/10.22551/MSJ.2021.01.12

  • BOGDANICI Margareta Camelia “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • ALEXA Anisia Iuliana “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • CIUNTU Roxana Elena “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • GIURGICA M. “Sf. Spiridon” County Clinical Emergency Hospital, Iasi
  • PANTALON Anca “Sf. Spiridon” County Clinical Emergency Hospital, Iasi
  • GRIGORAS C. “Sf. Spiridon” County Clinical Emergency Hospital, Iasi
  • OBADA Otilia “Sf. Spiridon” County Clinical Emergency Hospital, Iasi
  • NECHITA DUMITRIU Ionela “Sf. Spiridon” County Clinical Emergency Hospital, Iasi
  • ANTON Nicoleta “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

Within the current epidemiological context and due to the increased risk of infectivity, this article focuses on the practical activity of “Sf. Spiridon” Ophthalmology Clinic in Iaşi, during the emergency period (March 16th -May 16th, 2020), the evaluated ocular pathology and the approached strategy from the point of view of medical and surgical vision. Material and methods: As an Emergency Hospital and Tertiary Center of Moldova, Romania “Sf. Spiridon” Hospital in Iaşi was the only hospital in the region that dealt with all the urgent ophthalmological pathology during COVID-19. The clinic worked due to the established protocol, the patient’s circuit was changed, with the buffer zone for the suspicious COVID-19 patient, where the patient was hospitalized until the negative PCR result. All patients having a negative PCR test benefited from both medical and / or surgical treatment depending on the type of ocular pathology. Results: 619 patients were examined in the emergency room, of which 61 patients were hospitalized in Clinic I Ophthalmology, “Sf. Spiridon” Hospital in Iaşi, between March 16 and May 16, 2020. Most patients (59%) came from the neighboring counties (Suceava, Vaslui, Piatra Neamţ, Bacău) the rest being from Iaşi (41%). The age varied from 2 to 87 years, the average age being 51.72 ± 22.16. Most frequently, patients were hospitalized with retinal detachment (29.5%), trauma (24.6%) and corneal sclerosis (13.1%), most cases being surgical. The average length of stay was 6.3 days. The average time of surgery stages was 45 minutes. The condition at discharge was in 60% of cases improved and 30% cured. All patients tested negative for COVID-19 PCR. Visual acuity and IOP showed slightly higher / lower changes at discharge than at the time of admission. Depending on the diagnosis, the average stay for the patients with retinal detachment was about 4 days, while for patients with glaucoma (13 days) or ulcer corneal (12 days), the long-term hospitalization exceeded 12 days. The multivariate analysis showed that about 10% of the number of days spent in hospital (dependent variable) can be explained by the diagnosis of hospitalization and the type of intervention. Correlated with the status of discharge, the number of days spent in hospital did not differ significantly. Conclusions: Most of the ophthalmological activity during the pandemic was surgical, due to the large number of trauma cases from neighboring counties, being the only non-COVID-19 hospital in the North-eastern region of Romania. Complying with the protocol suggested by the American Academy of Ophthalmology for protection in the case of ophthalmic surgery allows standard eye care and safe surgery to maintain a sustainable application.

Author Biographies

BOGDANICI Margareta Camelia, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi
Department of Ophthalmology

ALEXA Anisia Iuliana, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi
Department of Ophthalmology

CIUNTU Roxana Elena, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi
Department of Ophthalmology

GIURGICA M., “Sf. Spiridon” County Clinical Emergency Hospital, Iasi

Department of Ophthalmology

PANTALON Anca, “Sf. Spiridon” County Clinical Emergency Hospital, Iasi

Department of Ophthalmology

GRIGORAS C., “Sf. Spiridon” County Clinical Emergency Hospital, Iasi

Department of Ophthalmology

OBADA Otilia, “Sf. Spiridon” County Clinical Emergency Hospital, Iasi

Department of Ophthalmology

NECHITA DUMITRIU Ionela, “Sf. Spiridon” County Clinical Emergency Hospital, Iasi

Department of Ophthalmology

ANTON Nicoleta, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi
Department of Ophthalmology

References

1. Li N, Yu X. Outbreak and Regression of COVID-19 Epidemic Among Chinese Medical Staff. Risk Manag Healthc Policy 2020; 13: 1095-1102.
2. Pottegård A, Kristensen KB, Reilev M, et al. Existing Data Sources in Clinical Epidemiology: The Danish COVID-19 Cohort. Clin Epidemiol 2020; 12: 875-881.
3. Kumari K, Kaur S, Sukhija J, Ram J. Coronavirus disease in ophthalmology practice: Current scenario; available evidence; and its implications. Cli Exp Vis Eye Res J 2020; 3: 6-12.
4. Recommendations for urgent and nonurgent patient care available on https://www.aao.org/headline/new-recommendations-urgent-nonurgent-patient-care.
5. Lim LW, Yip LW, Tay HW, et al. Sustainable practice of ophthalmology during COVID-19: challenges and solutions. Graefes Arch Clin Exp Ophthalmol 2020; 258(7): 1427-1436.
6. Bostanci Ceran B, Ozates S. Ocular manifestations of coronavirus disease 2019. Graefes Arch Clin Exp Ophthalmol 2020; 258(9): 1959-1963.
7. Du H, Zhang M, Zhang H, Sun X. Practical experience on emergency ophthalmic surgery during the prevalence of COVID-19. Graefes Arch Clin Exp Ophthalmol 2020; 258(8): 1831-1833.
8. Mike EV, Laroche D. Preserving Vision in the COVID-19 Pandemic: Focus on Health Equity. Clin Ophthalmol. 2020; 14: 2073-2077.
9. Sarma P, Kaur H, Medhi B, Bhattacharyya A. Letter to the editor: Possible role of topical povidone iodine in case of accidental ocular exposure to SARS-CoV-2. Graefes Arch Clin Exp Ophthalmol. 2020; 258(11): 2575-2578.
10. Li KKW, Joussen AM, Kwan JKC, Steel DHW. FFP3, FFP2, N95, surgical masks and respirators: what should we be wearing for ophthalmic surgery in the COVID-19 pandemic? Graefes Arch Clin Exp Ophthalmol 2020; 258: 1587-1589.
11. Dai J, Yang L, Zhao J. Probable Longer Incubation Period for Elderly COVID-19 Cases: Analysis of 180 Contact Tracing Data in Hubei Province, China. Risk Manag Health Policy 2020; 13: 1111-1117.
12. Danielescu C, Zugun-Eloae F, Zlei M. Concentrations of Vitreal Cytokines in Rhegmatogenous Retinal Detachment. Rev Med Chir Soc Med Nat Iasi 2016; 120(1): 124-129.
13. Danielescu C, Cantemir A, Chiselita D. Successful treatment of fungal endophthalmitis using intravi-treal caspofungin. Arq Bras Oftalmol 2017; 80(3): 196-198.
14. Anisia EI, Ciuntu RE, Cantemir A, Anton N et al The Importance of Fluconazole in Treatment of Endogenous Endophthalmitis in Patients Prior Treated Using Negative Pressure Therapy for Wound Closure Contaminated with Methicillin-resistant Staphylococcus aureus. Revista de Chimie 2017; ‏ 68(7): 1598-1601.
15. Ciuntu BM, Vasiluta C, Anton N, et al. Negative Pressure Therapy in Abdominal Compartment Syndrome, Revista de Chimie 2017; 68(8): 1923-1926.
16. Anton N, Cantemir A, Chiseliţa D. Influence of Glaucoma on Diabetes-Induced Changes in the Ante-rior Ocular Segment. Rev Med Chir Soc Med Nat Iasi 2016; 120(2): 336-343.
17. Danielescu C, Stanca HT, Balta F. The Management of Lamellar Macular Holes: A Review. J Oph-thalmol. 2020 Feb 21; 2020: 3526316.
18. Ciuntu BM, Georgescu SO, Cirdeiu C, et al. Negative Pressure Therapy in Wounds Surgical Treat-ment, Revista de Chimie 2017; 68(11): 2687-2690.
Published
2021-03-30