Impact of COVID-19 pandemic control measures on amblyopia treatment: a retrospective study of records from a tertiary eye hospital in China

• Published in: BMJ open Vol. 13; no. 7; p. e071839
• Main Authors: Liu, Jing, Ye, Qingqing, Xiao, Chutong, Zhuang, Yijing, Feng, Lei, He, Yunsi, Xu, Zixuan, Zhou, Yusong, Chen, Xiaolan, Yao, Ying, Jiang, Rengang, Pang, Yangfei, Yu, Wentong, Wen, Yun, Yuan, Junpeng, Thompson, Benjamin, Li, Jinrong
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 05-07-2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Amblyopia - epidemiology; Amblyopia - therapy; Child; China - epidemiology; Clinical outcomes; Communicable Disease Control; COVID-19; COVID-19 - epidemiology; Epidemics; Holidays & special occasions; Hospitals; Humans; Males; Ophthalmology; Optometry; Outpatient care facilities; paediatric ophthalmology; Pandemics; Patients; Pediatrics; Public Health; Retrospective Studies; Shelter in place; Statistical analysis; Tertiary Care Centers; Treatment Outcome; Visual acuity; China; COVID-19; public health; paediatric ophthalmology
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-071839

ObjectivesAmblyopia is the most common cause of unilateral visual impairment in children and requires long-term treatment. This study aimed to quantify the impact of pandemic control measures on amblyopia management.Design and settingThis was a retrospective cohort study of data from a large amblyopia management database at a major tertiary eye care centre in China.ParticipantsOutpatients with amblyopia who visited the hospital from 1 June 2019, through 28 February 2022.Primary and secondary outcome measuresThe primary outcome was the number of first and follow-up in-person visits to the hospital for amblyopia treatment. Secondary outcomes included the time interval between consecutive visits and improvement of vision (visual acuity, contrast sensitivity and stereopsis). Patient records were grouped into prepandemic and during pandemic periods.ResultsA total of 10 060 face-to-face visits for 5361 patients (median age 6.7 years, IQR 5.4, 8.9) that spanned two lockdown periods were included in the analysis, of which 28% were follow-up visits. Pandemic control measures caused a sharp decline in the number of outpatient visits (3% and 30% of prepandemic levels in the months directly after the start of the first (2020) and second (2021) periods of pandemic control measures, respectively). However, these drops were followed by pronounced rebounds in visits that exceeded prepandemic levels by 51.1% and 108.5%, respectively. The interval between consecutive visits increased significantly during the pandemic from a median (IQR) of 120 (112, 127) days in 2019 to 197 (179, 224) in 2020 (p<0.001) and 189 (182, 221) in 2021 (p<0.001). There were no significant differences in the improvement of visual function or treatment compliance between the prepandemic and postpandemic groups.ConclusionsThe number of amblyopia patient hospital visits spiked well above prepandemic levels following lockdown periods. This pattern of patient behaviour can inform planning for amblyopia treatment services during and after public health-related disruptions.