Acute primary angle closure during the Omicron outbreak
Authors:   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Fang Dong , Liang Jia ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Chen Lu ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Dou Ning-Xin ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Zheng Hui-Yan ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Huang Can-Feng ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Xie Ting ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Zhuang Yi-Jing ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Li Peng-Feng ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Mao Xing-Xing ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China, Zhang Shao-Chong ,   Shenzhen Eye Hospital, Jinan University, Shenzhen Key Laboratory of Ophthalmology, Shenzhen 518040, Guangdong Province, China
Published: June 2024

AIM: To investigate Omicron's impact on clinical presentation of acute primary angle closure (APAC) in China.
METHODS: A consecutive case series with historical controls was conducted at Shenzhen Eye Hospital, the largest specialized hospital in Shenzhen, China. Medical records from a two-month period during the Omicron pandemic (December 1, 2022, to January 31, 2023) were compared with records from two control groups (12/2018–1/2019 and 12/2021–1/2022) before pandemic. Patients with APAC were included, and the prevalence of APAC and demographic characteristics in Omicron-infected and non-infected patients were compared.
RESULTS: Seventy-one (23.43%) out of 303 patients were diagnosed with APAC in the pandemic cohort, which was 2.98 and 2.61 times higher than that in control cohorts (7.87% in 2019, 8.96% in 2022, P&#x003C;0.001). The pandemic cohort has significantly higher Omicron-infected rate (78.87% vs 0 vs 0; P&#x003C;0.001), lower proportion of glaucoma history (16.90% vs 42.86% vs 41.67%, P=0.005), higher surgical rate (95.77% vs 83.33% vs 78.57%, P=0.024), higher total medical costs and larger pupil diameter (5.63±0.15 vs 4.68±0.15 vs 4.69±0.22 mm, P&#x003C;0.01). In 83% Omicron-infected patients, ocular symptoms appeared within 3d after systemic symptoms onset. In multivariate analysis, Omicron infection (P&#x003C;0.001) was the only independent predictor of pupil diameter.
CONCLUSION: In the Omicron epidemic in China, there is an increase of prevalence and severity of APAC, particularly focusing on the first 3d following infection.