Impact of COVID-19 Outbreak on Retinopathy of Prematurity Screening

Year 2022, Volume: 8 Issue: 3, 333 - 339, 31.08.2022

Asena Keleş Şahin , Aslıhan Uzun

https://doi.org/10.19127/mbsjohs.1072251

Abstract

Objective: To evaluate the impact of COVID-19 outbreak on screening of premature babies for retinopathy of prematurity (ROP).
Methods: Medical records of infants who underwent ROP screening at Ordu University, Training and Research Hospital were reviewed, retrospectively. Sixty premature babies who were not brought into their follow-up visits and reported to the Child, Adolescent, Woman and Reproductive Health (CEKUS) unit between March 2020 and March 2021 were included. The patients were divided into 4 groups according to the timing of CEKUS reports; Group 1: March-May 2020, Group 2: June-August 2020, Group 3: September-November 2020, and Group 4: December 2020-February 2021.
Results: A total number of 60 babies were reported to the CEKUS unit between March 2020 and March 2021. While 18% of the patients were consulted from our neonatal intensive care unit (NICU), 82% of the infants were referred from other NICUs. The parents of only 17 (28%) of all patients were living in Ordu, additionally. Compared to the total number of patients reported to the CEKUS unit in the last year before the onset of the pandemic, a decrease in compliance with the appointments was observed after the announcement of the first COVID-19 case in Turkey (p<0.001). Adherence to the appointments increased in the period when COVID-19 patients decreased. When the COVID-19 cases began to rise again significantly after November (Group 4), the number of CEKUS reports increased correspondingly. However, there was no significant correlation between the number of CEKUS reports and the total number of COVID-19 cases in the groups (p = 0.600, r = 0.400).
Conclusion: In addition to the difficulty of screening for ROP since the onset of the COVID-19 outbreak, the follow up of babies who are not brought in has become a serious problem. A decrease in adherence to appointments was observed after the beginning of the COVID-19 pandemic. An institution such as our CEKUS unit may help the ophthalmologists and neonatologists to complete all screening sessions. Most babies that were not brought in to ROP screening, were also the ones referred from other NICUs and those who lived in neighboring cities, in our study. Therefore, increasing the number of ROP units may also prevent the non-adherence of the parents.

Keywords

COVID-19, premature, retinopathy of prematurity, screening

Supporting Institution

Bulunmamaktadır.

Project Number

Bulunmamaktadır.

Thanks

First, we would like to thank our nurse of ROP unit, Merve Şura Yayla, for her great sacrifice in the operation of the CEKUS reports. We would also like to thank the director of Public Health Services of Ordu Provincial Health Directorate dealing with the CEKUS unit, Fatih Aydın, MD, for taking responsibility for the follow up of babies that were not brought in. Finally, we would like to thank all the CEKUS team and family physicians who ensured the referral of all patients to the ROP unit.

References

• 1. Sommer A, Taylor HR, Ravilla TD, et al; Council of the American Ophthalmological Society. Challenges of ophthalmic care in the developing world. JAMA Ophthalmol. 2014;132(5):640-4.
• 2. Chan-Ling T, Gole GA, Quinn GE, et al. Pathophysiology, screening and treatment of ROP: A multi-disciplinary per- spective. Prog Retin Eye Res. 2018;62:77- 119. PMID: 28958885.
• 3. Revised National Guideline on Retinopathy of Prematurity, published in 2021. http://www.neonatology.org.tr/wp-content/uploads/2022/01/Turkiye-Premature-Retinopatisi-Rehberi-2021-Guncellemesi.pdf
• 4. The Ministry of Health COVID-19 Information Platform. https://covid19.saglik.gov.tr/TR-66935/genel-koronavirus-tablosu.html
• 5. American Academy of Ophthalmology. (2020). List of urgent and emergent ophthalmic procedures. https://www.aao.org/headline/list-of-urgent-emergent-ophthalmic-procedures
• 6. Turkish Ophthalmological Association. (2020). Eye Surgery Considered Urgent Due to Pandemic. https://koronavirus.todnet.org/pandemi-nedeni-ile-acil-kabul-edilen-gz-ameliyatlar
• 7. Katoch D, Singh SR, Kumar P. Impact of the COVID-19 Pandemic on Retinopathy of Prematurity Practice: An Indian Perspective. Indian Pediatr. 2020 Oct 15;57(10):979-980.
• 8. Mahajan V, Singh T, Azad C. Using Telemedicine During the COVID-19 Pandemic. Indian Pediatr. 2020 Jul 15;57(7):652-657. Epub 2020 May 14. PMID: 32412914.
• 9. Bokolo Anthony Jnr. Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic. J Med Syst. 2020 Jun 15;44(7):132. doi: 10.1007/s10916-020-01596-5. PMID: 32542571; PMCID: PMC7294764.
• 10. Ravindran M, Segi A, Mohideen S, et al. Impact of teleophthalmology during COVID-19 lockdown in a tertiary care center in South India. Indian J Ophthalmol. 2021 Mar;69(3):714-718. doi: 10.4103/ijo.IJO_2935_20. PMID: 33595507; PMCID: PMC7942072.
• 11. Guo Z, Ma N, Wu Y, Yuan H, Luo W, Zeng L, Jie H, Li S. The safety and feasibility of the screening for retinopathy of prematurity assisted by telemedicine network during COVID-19 pandemic in Wuhan, China. BMC Ophthalmol. 2021 Jun 11;21(1):258. doi: 10.1186/s12886-021-02018-x. PMID: 34112134; PMCID: PMC8192130.
• 12. Isaac M, Isaranuwatchai W, Tehrani N. Cost analysis of remote telemedicine screening for retinopathy of prematurity. Can J Ophthalmol. 2018 Apr;53(2):162-167. doi: 10.1016/j.jcjo.2017.08.018. Epub 2017 Nov 14. PMID: 29631829.