ABSTRACT
Objectives: Globally, cataract and glaucoma are the predominant causes of blindness. Screening glaucoma in patients referred for cataract surgery is a convenient tool for detecting glaucoma cases in rural population. The COVID period has adversely affected eye care as the routine screening and follow-ups at hospital were substantially reduced owing to pandemic restrictions. We aim to study the impact of COVID on detection of glaucoma in patients with cataract. Method(s): It was a retrospective study conducted to compare the prevalence of glaucoma in rural patients presenting with cataract pre- and post-COVID. Details of 975 consecutive patients each were taken prior to March 2020 (pre-COVID) and after October 2021 (post-COVID) from hospital database and patient case files. Result(s): The prevalence of glaucoma was higher during the pre-COVID time (3.8%) as compared to pre-COVID (3.8%), but the result was not statistically significant. In both the groups, primary open-angle glaucoma was the pre-dominant form of glaucoma, with prevalence being 1.5% and 2.2% in the pre-COVID and post-COVID groups, respectively. The mean intraocular pressure and mean VCDR values were higher in the post-COVID group as compared to the pre-COVID group, and the result was statistically significant. Conclusion(s): This was the first study to compare the prevalence of glaucoma in patients with cataract in rural population in the pre-COVID and post-COVID periods. In the aftermath of the pandemic, the present study emphasizes the role of screening and follow-ups in glaucoma management to prevent irreversible loss of vision.Copyright © 2023 The Authors.
ABSTRACT
A 40-year-old male patient, an office worker, is a hospital staff. He applied with the complaint of sudden onset of blurred vision in the right eye. He stated that he had the first dose of inactivated covid vaccine (sinovac) 4 days ago in his story. In his examination, his vision was 0.5 in the right eye, 1.0 in the left eye, and his intraocular pressure was in both eyes. It was at the level of 15 mmHg. Biomicroscopically, the anterior segment looked natural. CSC was diagnosed in the FFA and OCT examinations.Treatment with oral acetazolamide (2x250 mg), topical nepafanac (4x1) was started. On the 13th day of the treatment, there was insufficient improvement in clinical findings, and oral acetazolamide was used. The dose was reduced (2x125 mg), oral epleronone (50 mg) was added. On the 70th day of the treatment, the vision in the right eye increased to full level in the control examination and it was observed that the retina returned to its normal appearance in the OCT examination.Copyright © 2023 Gazi Eye Foundation. All rights reserved.
ABSTRACT
BACKGROUND: Branch retinal vein occlusion (BRVO) has an incidence of 0.5-1.2%. COVID-19 is associated with both venous and arterial thromboembolisms due to excessive inflammation, hypoxia, immobilization, and diffuse intravascular coagulation. AIM: The present study aims to describe our experience with BRVO in Egyptian COVID-19 patients. PATIENTS AND METHODS: The present retrospective study included 17 polymerase chain reaction (PCR)-proven COVID-19 patients with BRVO. Data obtained from the studied patients included detailed history taking. In addition, patients were diagnosed with BRVO based on a comprehensive ophthalmic evaluation, including logMAR Best-corrected visual acuity assessment, slit-lamp bio-microscopy, fundoscopy, fundus fluorescein angiography, and optical coherence tomography macular assessment. RESULT(S): The present study included 17 PCR-proven COVID-19 patients with BRVO. They comprised 9 males (52.9%) and 8 females (47.1%) with an age of 52.8 +/- 13.3 years. Fundus examination revealed BRVO as superior temporal in 9 patients (52.9%), inferior temporal in 5 patients (29.4%), superior nasal in 2 patients (11.8%), and inferior nasal in 1 patient (5.9%). The reported retinal thickness was 355.7 +/- 41.7 microm. In addition, fundus fluorescein angiography identified ischemic changes in 2 patients (11.8%). CONCLUSION(S): BRVO is a rare severe complication of COVID-19 infection. In patients with proven or suspected infection with a diminution of vision, there should be high suspicion of BRVO and prompt full-scale ophthalmological examination to exclude the condition. Copyright © 2022 Sanaa Ahmed Mohamed, Marwa Byomy, Eman El Sayed Mohamed El Sayed, Mostafa Osman Hussein, Marwa M. Abdulrehim, Ahmed Gomaa Elmahdy.
ABSTRACT
Purpose : COVID-19 pandemic has become a major global public health challenge. The ophthalmology office setting involves close encounters between the patient and the health care workers increasing risk of viral transmission. Use of PPE decreases risk of person-to-person viral transmission. The purpose of the study was to evaluate breath-induced air currents in subjects without a facemask, with a procedure mask, with an improvised face, and in the setting of slit-lamp examination. Methods : Breath-induced air currents were studied in healthy volunteers utilizing a vape pod system and videography during gentle and heavy breathing simulation. Video frames at 2 seconds after the initiation of expiration were captured and analyzed. Results : A total of 210 recordings were made for 7 settings. Without a face mask, the aerosol moved forwards and spread vertically and horizontally reaching a mean distance of 23.1 inches for gentle, and 36.1 inches for heavy breathing at 2 seconds (P< 0.001). Using PPE the airflow patterns included: a) procedure mask- forward 0 cases, upward 19 (63%) cases, side 28 (93%) cases, downward 22 (73%) cases, and backward 22 (73%) cases. Adding a tape at the upper border of the mask eliminated upward flow in all cases. b) Improvised face mask- forward 0 cases, upward 0 cases, side 30 (100%) cases, downward 30 (100%) cases, and backward 17 (57%) cases. In 14 (47%) cases trace of aerosol was detected adjacent to the front surface of the mask. Adding a second layer eliminated the trace of aerosol in all cases. In the setting of simulated slit-lamp examination without the breath shield, the aerosol reached the chin rest in 9 (60%) cases during gentle breathing and in all cases during heavy breathing. The breath shield was effective in blocking forward airflow in all cases. Conclusions : Use of a procedure mask by patients, while effective in blocking forward breath-induced airflow, redirects the flow upwards, potentially increasing the risk of contamination during an office procedure. An improvised facemask alters breath-induced air currents favorably and partially absorbs respiratory droplets.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was declared a pandemic by the World Health Organization on 11 March 2020 has been reported in most countries around the world since its origins in Wuhan, China. As of September 2021, there have been over 229 million cases of COVID-19 reported worldwide, with over 4.7 million COVID-19–associated deaths. Body: The devastating second wave of the COVID-19 pandemic in India has seen a rise in various extrapulmonary manifestations. One of key components in the pathogenesis of COVID-19 is downregulation of ACE-2, which is expressed on many organs and counterbalances the pro-inflammatory effects of ACE/angiotensin-II axis. This leads to influx of inflammatory cells into alveoli, increased vascular permeability and activation of prothrombotic mediators. Imaging findings such as ground glass opacities, interlobular septal thickening, vascular dilatation and pulmonary thrombosis correlate well with the pathogenesis. Conclusion: We hypothesize that the systemic complications of COVID-19 are caused by either direct viral invasion or effect of cytokine storm leading to inflammation and thrombosis or a combination of both. Gaining insights into pathobiology of SARS-CoV-2 will help understanding the various multisystemic manifestations of COVID-19. To date, only a few articles have been published that comprehensively describe the pathophysiology of COVID-19 along with its various multisystemic imaging manifestations.