Abstract
Purpose :
To evaluate the relationship between COVID-19 case volume and ophthalmic procedural volume during the pandemic.
Methods :
A retrospective cohort study using TriNetX (Cambridge, MA, USA), a federated electronic health records research network comprising multiple large health organizations in the United States. Monthly Current Procedural Terminology (CPT)-specific volumes per HCO were clustered chronologically to calculate average volumes into three-month seasons to calculate average volumes. Seasonal averages from a combination of 2018 and 2019 data were used to provide a baseline comparison to pre-pandemic procedural volume. An aggregate of the total pandemic period (March 2020 - August 2021) was compared to the corresponding figures in pre-pandemic timeframes.
Results :
670,541 unique ophthalmic procedures from among 573 HCOs between March 2018 and August 2021 were included. Intravitreal injections was the most prevalent procedure with 320,106 occurrences. Phacoemulsification cataract surgery was the second most prevalent (N = 176,095) procedure with 144,816 uncomplicated (82.2%) and 31,279 complicated (17.8%). Intravitreal injections had the highest mean seasonal volume per HCO for each of the five COVID-19 pandemic seasons. From March 2020 – August 2021, a mean pandemic volume of 266.7 (SD = 15) was observed, a 5% decrease (p<0.05) in procedures compared to pre-pandemic mean of 280.8 (SD = 26.1).
During the five COVID-19 pandemic seasons, the seasonal mean volume almost always differed from pre-pandemic comparisons. Spring 2020 exhibited the sharpest seasonal decrease in procedural volume (88%). Spring 2021 had the largest count of significant increase in procedure volume (18%). Aggregate mean volume per HCO showed significant decreases for 11 out of 17 procedures in the 12-month March 2020-February 2021 timeframe and significant decreases for 10/17 procedures over the 18-month March 2020-August 2021 timeframe. A relative inverse relationship between COVID-19 case volume and ophthalmic procedure volume was observed.
Conclusions :
This study highlights the relative inverse relationship between COVID-19 cases and ophthalmic procedure volume in the US. Reduction in procedural volume may result in delayed care with potential for vision loss. Awareness and understanding of these trends could help ophthalmologists prepare should a similar cycle occur in the setting of the omicron and future variants.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.