Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children
Purpose: The novel coronavirus SARS-CoV-2 (COVID-19) and the resultant nationwide lockdown and travel restrictions led to difficulty in providing timely and regular treatment to patients with childhood cancers such as retinoblastoma. This study is aimed at assessing the demography, clinical presenta...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
|
| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=10;spage=2617;epage=2624;aulast=Bansal |
| _version_ | 1818588275117391872 |
|---|---|
| author | Rolika Bansal Ankita Aishwarya Raksha Rao Marem C Christy Mrittika Sen Harika Regani Poonam Bagai Vijay A Reddy Kaustubh Mulay Pramila Bongoni Santosh G Honavar |
| author_facet | Rolika Bansal Ankita Aishwarya Raksha Rao Marem C Christy Mrittika Sen Harika Regani Poonam Bagai Vijay A Reddy Kaustubh Mulay Pramila Bongoni Santosh G Honavar |
| author_sort | Rolika Bansal |
| collection | DOAJ |
| description | Purpose: The novel coronavirus SARS-CoV-2 (COVID-19) and the resultant nationwide lockdown and travel restrictions led to difficulty in providing timely and regular treatment to patients with childhood cancers such as retinoblastoma. This study is aimed at assessing the demography, clinical presentation, treatment strategies, and outcome of treatment defaulters due to the lockdown. Methods: Cross-sectional, observational study of retinoblastoma patients at a tertiary care ocular oncology center during the first wave of COVID-19 and the resulting nationwide lockdown. Results: Of the 476 eyes of 326 patients undergoing active management with a median age of 57 months (range: 4–214 months), 205 (63%) patients returned for follow-up after a mean delay of 45.8 ± 24.3 weeks (range: 8–80 weeks) and 121 (37%) were defaulters according to the data analyzed till June 30, 2021. Distance of residence was ≥1000 km for 148 patients (46%). In terms of need for active treatment, the number of emergent cases was 2 (<1%), 11 (3%) were urgent, and 313 (96%) were semi-urgent. International classification groups D (n = 107 eyes, 23%) and E (n = 173 eyes, 36%) were in majority, and 13 eyes (4%) and 4 eyes (1%) were at stages 3 and 4, respectively. Prior to lockdown, 86 eyes (18%) had active tumor, which remained unchanged (n = 26, 30%) or worsened (n = 49, 60%) after failure to follow-up. Vision (47%), eye (92%), and life salvage (98%) were achieved by individualized protocol-based management after the patients returned for further management. Five children succumbed to intracranial extension. Conclusion: The COVID-19-related nationwide lockdown has deprived retinoblastoma patients of optimal and timely management, leading to prolonged treatment interruptions, delays, permanent default, and death. It is of paramount importance for all the stakeholders to increase awareness, make necessary travel and logistic arrangements, and ensure continuity of care for children with retinoblastoma. |
| first_indexed | 2024-12-16T09:22:10Z |
| format | Article |
| id | doaj.art-8dcc8a69b9a14d2b90ad0a91a0118c9b |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-12-16T09:22:10Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-8dcc8a69b9a14d2b90ad0a91a0118c9b2022-12-21T22:36:44ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892021-01-0169102617262410.4103/ijo.IJO_2243_21Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 childrenRolika BansalAnkita AishwaryaRaksha RaoMarem C ChristyMrittika SenHarika ReganiPoonam BagaiVijay A ReddyKaustubh MulayPramila BongoniSantosh G HonavarPurpose: The novel coronavirus SARS-CoV-2 (COVID-19) and the resultant nationwide lockdown and travel restrictions led to difficulty in providing timely and regular treatment to patients with childhood cancers such as retinoblastoma. This study is aimed at assessing the demography, clinical presentation, treatment strategies, and outcome of treatment defaulters due to the lockdown. Methods: Cross-sectional, observational study of retinoblastoma patients at a tertiary care ocular oncology center during the first wave of COVID-19 and the resulting nationwide lockdown. Results: Of the 476 eyes of 326 patients undergoing active management with a median age of 57 months (range: 4–214 months), 205 (63%) patients returned for follow-up after a mean delay of 45.8 ± 24.3 weeks (range: 8–80 weeks) and 121 (37%) were defaulters according to the data analyzed till June 30, 2021. Distance of residence was ≥1000 km for 148 patients (46%). In terms of need for active treatment, the number of emergent cases was 2 (<1%), 11 (3%) were urgent, and 313 (96%) were semi-urgent. International classification groups D (n = 107 eyes, 23%) and E (n = 173 eyes, 36%) were in majority, and 13 eyes (4%) and 4 eyes (1%) were at stages 3 and 4, respectively. Prior to lockdown, 86 eyes (18%) had active tumor, which remained unchanged (n = 26, 30%) or worsened (n = 49, 60%) after failure to follow-up. Vision (47%), eye (92%), and life salvage (98%) were achieved by individualized protocol-based management after the patients returned for further management. Five children succumbed to intracranial extension. Conclusion: The COVID-19-related nationwide lockdown has deprived retinoblastoma patients of optimal and timely management, leading to prolonged treatment interruptions, delays, permanent default, and death. It is of paramount importance for all the stakeholders to increase awareness, make necessary travel and logistic arrangements, and ensure continuity of care for children with retinoblastoma.http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=10;spage=2617;epage=2624;aulast=Bansalcovid-19ocular oncologyretinoblastomasars-cov-2treatment delay |
| spellingShingle | Rolika Bansal Ankita Aishwarya Raksha Rao Marem C Christy Mrittika Sen Harika Regani Poonam Bagai Vijay A Reddy Kaustubh Mulay Pramila Bongoni Santosh G Honavar Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children Indian Journal of Ophthalmology covid-19 ocular oncology retinoblastoma sars-cov-2 treatment delay |
| title | Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children |
| title_full | Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children |
| title_fullStr | Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children |
| title_full_unstemmed | Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children |
| title_short | Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children |
| title_sort | impact of covid 19 nationwide lockdown on retinoblastoma treatment and outcome a study of 476 eyes of 326 children |
| topic | covid-19 ocular oncology retinoblastoma sars-cov-2 treatment delay |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=10;spage=2617;epage=2624;aulast=Bansal |
| work_keys_str_mv | AT rolikabansal impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT ankitaaishwarya impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT raksharao impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT maremcchristy impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT mrittikasen impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT harikaregani impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT poonambagai impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT vijayareddy impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT kaustubhmulay impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT pramilabongoni impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children AT santoshghonavar impactofcovid19nationwidelockdownonretinoblastomatreatmentandoutcomeastudyof476eyesof326children |