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1.
Case Reports in Ophthalmology ; 13(2):350-354, 2022.
Article in English | ProQuest Central | ID: covidwho-2027103

ABSTRACT

Plants of the Araceae family exude a sap containing calcium oxalate, a toxic substance that causes dermatitis. However, ocular injury due to exposure to Araceae sap has rarely been reported. Herein, we present a case of severe pseudomembranous conjunctivitis following exposure to Arisaema ringens, an Araceae species and popular houseplant in Japan. A 67-year-old man presented with pain in his right eye after exposure to the sap of A. ringens. At presentation, the best corrected visual acuity and intraocular pressure in the right eye were 20/800 and 15 mm Hg. Slit-lamp examination showed strong hyperemia, conjunctival chemosis, and corneal edema with many pseudomembranes, and fluorescein staining revealed corneal epithelial defects in the central area of the cornea. We washed the ocular surface with saline and initiated treatment with topical instillations of 1.5% levofloxacin and 0.1% betamethasone, combined with ofloxacin eye ointment. After repeatedly removing the pseudomembranes and increasing the frequency of the topical instillations, pseudomembranous conjunctivitis and corneal erosion gradually improved. One week following the injury, the corneal epithelial defects were no longer detectable, and the patient’s best corrected visual acuity recovered to 20/25. It is important for ophthalmologists and primary care physicians to be aware of the ocular toxicity of A. ringens and should counsel their patients accordingly. Moreover, preventative measures, such as the use of protective eyewear, should be taken when cutting this houseplant.

2.
Experimental & Clinical Transplantation: Official Journal of the Middle East Society for Organ Transplantation ; 20(Suppl 4):70-73, 2022.
Article in English | MEDLINE | ID: covidwho-2025258

ABSTRACT

OBJECTIVES: In this study, we aimed to analyze the effects of the COVID-19 pandemic in its first year on corneal transplant outcomes performed at a tertiary eye care center in Turkey. MATERIALS AND METHODS: Clinical records of patients who underwent corneal transplant between March 2020 and February 2021 (group A) at the Baskent University Faculty of Medicine, Department of Ophthalmology, were analyzed retrospectively. Patient demographics, indications for transplant, type of transplant procedure (lamellar vs penetrating), follow-up duration, and postoperative complications were recorded. The same data were collected for cornea transplant patients who were seen the previous year, between March 2019 and February 2020 (group B). Data from the 2 groups were compared. In related samples, the Wilcoxon signed rank test was used for statistical analysis, and a P value < .05 was considered statistically significant. RESULTS: Six corneal transplants were performed between March 2020 and February 2021 (group A), and 48 corneal transplantations were performed in the previous year (group B). There was an 80% decline in total corneal transplant numbers when compared with the previous year, and lamellar surgeries were not performed at all during the first year of the pandemic. Indications during the pandemic were mainly urgent and limited to tectonic or therapeutic causes. Postoperative follow-up regimens were impaired, and the complication rate was significantly higher during the pandemic period compared with the previous year (67% in group A vs 16% in group B) (P < .001). CONCLUSIONS: There was a steep decline in transplants in 2020, the first year of the pandemic. The prominent increase in complication rates can be attributed to the late diagnosis of corneal rejections due to impaired postoperative follow-up regimens.

3.
Indian Journal of Ophthalmology ; 70(9):3289-3293, 2022.
Article in English | MEDLINE | ID: covidwho-2024722

ABSTRACT

Purpose: To describe the causes and trends of corneal donor mortality from eye bank data in India during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This retrospective eye bank-based study included 13,529 donors who donated their cornea between January 2018 and December 2021. Donors in whom the cause of mortality was documented were included as cases. The data were collected from the eye bank records. Results: Overall, 13,529 corneal donors were included in the study. Most of the donors were males (69.71%). The mean age of the donors was 51.55 +/- 20.54 years, whereas the median age was 51 (inter-quartile range: 35-68) years. The mean age of males (49.3 +/- 19.47 years) was lesser than the mean age of females (56.72 +/- 21.94 years) at the time of donation. The most common age group at the time of donation was during the sixth decade of life with 2,139 (15.81%) donors. The mean age of the donors decreased by a decade from 54.95 +/- 20.51 years in 2018 to 44.35 +/- 18.88 years in 2021. The most common cause of donor mortality was cardio-respiratory arrest in 5,190 (38.36%) donors and trauma in 3,469 (25.64%) donors, followed by suicide in 2,790 (20.62%) donors. The trend of cardio-respiratory arrest decreased from 53.01% to 9.5% (p = <0.00001), whereas the trends of trauma increased from 21.93% to 36% (p = <0.00001) and suicide increased from 12.71% to 36.41% (p = <0.00001) between 2018 and 2021. Conclusion: Corneal donors are more commonly males in their sixth decade of life. The most common cause of donor mortality was related to cardio-respiratory arrest with a concerning rising trend in suicide cases over the years seen significantly during the pandemic.

4.
Journal of Personalized Medicine ; 12(8):1316, 2022.
Article in English | ProQuest Central | ID: covidwho-2023831

ABSTRACT

The changes in subfoveal choroidal thickness after orthokeratology are crucial in myopia retardation;this study aimed to identify the risk factors that could be incorporated into a predictive model for subfoveal choroidal thickness (SFChT) that would provide further personalized and clinically specific information for myopia control. A one-year prospective study was conducted in the West China Hospital, Sichuan University. Basic information (age, gender, and height) was collected from all subjects. Initial spherical equivalent, axial length, intraocular pressure, central corneal thickness, and subfoveal choroidal thickness were measured, and the ocular environmental factors were also collected. All the measured parameters were recorded in the follow-up period for one year. After the analysis of univariate analysis, statistically significant factors were substituted into the multivariate three-level model. Thirty-three adolescents aged 8–14 years old were enrolled in this study;the results show that the subfoveal choroidal thickness in both eyes changed significantly after 12 months of lens wearing (pR < 0.0001, pL < 0.0001). The axial length was negatively correlated with the change in the SFChT after 12 months of lens wearing (r = −0.511, p = 0.002). After multilevel model analysis, the statistically significant factor was shown to have an important influence on the changes in the subfoveal choroidal thickness, which was the average near-work time. This suggested that the SFChT personal predictions can be made regarding changes in myopic adolescents after orthokeratology using the factor of daily average near-work time. Clinical practitioners will benefit from the results by obtaining a better understanding of the effects of orthokeratology on choroid and myopia progression.

5.
Annals of the Rheumatic Diseases ; 81:1327-1328, 2022.
Article in English | EMBASE | ID: covidwho-2008917

ABSTRACT

Background: Current pharmacological treatments remain inadequate for a signifcant proportion of patients with rheumatoid arthritis (RA), and thus alternative treatment approaches are needed. Prior results from the frst 12 weeks of a proof-of-concept (POC) study showed that ATHENS, a non-invasive high-frequency vagus nerve therapy, was well-tolerated with meaningful reductions in RA disease severity as measured by the American College of Rheumatology response criteria (ACR) and the Disease Activity Score using 28 joints (DAS28)[1]. Objectives: The current analysis assessed long-term changes (52 weeks total follow-up) in disease activity as measured by ACR, DAS28, and the following MRI-assessed changes: synovitis, osteitis, bone erosion, and cartilage loss. Methods: Following the completion of the 12-week POC study, patients achieving a reduction in DAS28-CRP of ≥1.2 were given the option to enroll in the 9-month open-label extension (OLE) study. During the extension phase, patients were to use the wearable device for 15 minutes per day. Adjustment of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biologic disease-modifying antirheumatic drugs (bDMARDs) were allowed during the OLE. Changes from baseline were assessed at 12 weeks (end of initial POC) and 52 weeks (end of the OLE). Structural damage and disease progression were evaluated by standardized MRI of the wrist and hand, with and without intravenous gadolinium-based contrast. MRIs were evaluated by two independent, central readers, blinded to clinical information and visit-order of the images, and were scored for synovitis, osteitis and bone erosion using the OMERACT-RAM-RIS method. Cartilage loss was also determined using the 9-point cartilage loss scale (CARLOS). Results: Twenty-seven of 30 patients completed the initial 12-week study, of whom 19 consented and entered the OLE. Of those 19 patients, 4 (21%) discontinued due to lack of efficacy, while the remaining 15 completed the 9-month extension. Due to the COVID-19 pandemic, 7 patients were unable to complete a 52-week MRI scan;MRI evaluations at baseline, 12 weeks, and 52 weeks were available for 8 patients. DAS28-CRP mean (standard deviation [SD]) change from baseline was-1.78 (1.01) at 12 weeks (n=19;p<0.0001) and-2.30 (1.22) at 52 weeks (n=15;p<0.0001). ACR20, ACR50, and ACR70 response rates were 68%, 42%, and 21% at 52 weeks (n=19;discontinued participants were deemed non-responders). MRI analysis of synovitis, osteitis, bone erosion, and cartilage loss showed no evidence of disease progression through 52 weeks compared with baseline (Table 1). During the 9-month extension study, two new adverse events were reported (cornea transplant and right hand dysesthesia) in 2 (11%) patients;neither was treatment-related and both resolved without intervention. No serious adverse events were reported. Conclusion: In patients with an initial treatment response to the Nēsos ATHENS therapy in the 12-week POC study, reductions in DAS28-CRP were sustained through 52 weeks. Although results should be interpreted cautiously given the small sample size and lack of control arm, MRI evaluation of synovitis, osteitis, bone erosion, and cartilage loss suggested no disease progression.

6.
The Journal of craniofacial surgery ; 33(5):1300-1302, 2022.
Article in English | MEDLINE | ID: covidwho-2008691

ABSTRACT

: To report 2 successfully managed cases of graft rejection with acellular porcine corneal stroma (APCS) transplantation in patients with fungal corneal ulcer. Two patients were diagnosed with fungal corneal ulcer and received APCS transplantation. Graft rejection developed due to the lost follow-up during the period of coronavirus disease 2019 outbreak. Amniotic membranes transplantation and cauterization of neovascularization was performed, respectively. The graft failure resolved successfully after the procedure. To the best of our knowledge, amniotic membranes transplantation and cauterization of new vessels are the firstly reported in treating APCS graft failure. Amniotic membranes transplantation or cauterization of neovascularization appear to be a safe and costeffective method for treating graft failure.

7.
BMJ Open Ophthalmology ; 7(1), 2022.
Article in English | ProQuest Central | ID: covidwho-1993032

ABSTRACT

Correspondence to Dr Bernhard Steger;bernhard@steger.tirol In the current issue of BMJ Open Ophthalmology, Downward et al,1 on behalf of the UK National Health Service Blood and Ocular Tissue Advisory Group and Contributing Ophthalmologists, investigate long-term graft survival and rejection rates in patients who received corneas from donors who donated both corneas for Fuchs’ endothelial dystrophy or pseudophakic bullous keratopathy (PBK), defined as ‘paired’ donors. In response to this problem, England recently switched to an opt-out organ donation policy aiming to close the annual gap of approximately 1500 corneas, despite importing tissue from the USA and European Union (EU).10 However, the effect of this step remains to be quantified, being temporarily masked by a relative donor shortage due to Brexit and the aftermath of the COVID-19 pandemic, which significantly affected eye bank donor cornea procurement on a global scale.11 In addition, compared with other eye bank systems, such as in USA or Italy, the postmortem times such as death to retrieval, retrieval to processing and processing to issue may be skewed to being longer in the UK. The findings reported in this issue should push eye banks to try to keep improving postmortem times, and also to push basic science research into looking for novel, alternative ways to measure the true heath of endothelial cells as well as improving their health to increase graft survival.

8.
Front Med (Lausanne) ; 9: 983580, 2022.
Article in English | MEDLINE | ID: covidwho-1987514
9.
Spektrum Augenheilkd ; : 1-7, 2022 Jul 26.
Article in English | MEDLINE | ID: covidwho-1971726

ABSTRACT

Background: We aimed to compare optical biometric measurements using optical biometry in patients with previously received COVID-19 treatment and a control group. Methods: In this cross-sectional study, patients with previously received COVID-19 treatment formed the COVID-19 group and age- and sex-matched healthy participants formed the control group. Optical biometric measurements including keratometry, corneal astigmatism, astigmatic axis, central corneal thickness, anterior chamber depth, and axial length were made using a Nidek optical biometer (AL-Scan; Nidek Co., Ltd., Japan). Results: Measurements of keratometry (p = 0.79), corneal astigmatism (p = 0.41), axial length (p = 0.96), anterior chamber depth (p = 0.59), and central corneal thickness (p = 0.37) were similar between the COVID-19 and control groups. The astigmatic axis type taken from 2.4 mm of the cornea showed significant difference between the two groups (p = 0.02, χ2), while the measurements taken from 3.3 mm of the cornea were similar (p = 0.10, χ2). In the subgroup analysis, axial length, anterior chamber depth, and central corneal thickness measurements were found to be statistically significantly higher in male patients of the COVID-19 group (p = 0.02; p = 0.001; p = 0.02, t test). Conclusion: The changes in optical biometric measurements found in our study were due to the fact that COVID-19 is more frequent and severe in males, SARS-CoV­2 can attach to the cornea via ACE­2 receptors, and favipiravir can reach the aqueous humor. To our knowledge, there is no study on this subject to date, and therefore more research is needed to shed light on this topic.

10.
Graefes Arch Clin Exp Ophthalmol ; 2022 Aug 03.
Article in English | MEDLINE | ID: covidwho-1971706

ABSTRACT

PURPOSE: To study the possibility of SARS-CoV-2 to infect human corneal cells and tissues under standard corneal culture conditions using explants of COVID-19 donors and primary cornea-derived epithelial cells. METHODS: Cornea isolated from deceased COVID-19 donors was cultured for 4 weeks, and SARS-CoV-2 replication was monitored by qRT-PCR. Furthermore, primary corneal epithelial cells from healthy donors were cultured ex vivo and infected with SARS-CoV-2 and human cytomegalovirus (HCMV) as a control. Infection status was assessed by western blotting and reporter gene expression using green fluorescent protein-expressing viral strains. ACE2 and TMPRSS2 receptor expression levels in cornea and epithelial cells were assessed by qRT-PCR. RESULTS: We did not detect SARS-CoV-2 replication in 10 corneas isolated from deceased COVID-19 patients and cultured for 4 weeks, indicating absence of infection under natural conditions. Furthermore, high-titer SARS-CoV-2 infection of ex vivo cultured cornea-derived epithelial cells did not result in productive virus replication. In contrast, the same cells were highly permissive for HCMV. This phenotype could potentially be explained by low ACE2 and TMPRSS2 transcriptional activity in cornea and cornea-derived epithelial cells. CONCLUSIONS: Our data suggest that cornea and limbal epithelial cells are refractory to productive SARS-CoV-2 infection. This could be due to the absence of robust receptor expression levels necessary for viral entry. This study adds further evidence to support the very low possibility of transmission of SARS-CoV-2 from an infected corneal transplant donor to a recipient in corneal organ cultures.

11.
BMJ Open Ophthalmology ; 7:A2, 2022.
Article in English | EMBASE | ID: covidwho-1968306

ABSTRACT

Objective The benefits of simulation model and wet lab training courses have been well publicised. We were keen to introduce DMEK service in our NHS trust and put simulation and wet-lab training courses to the test for corneal consultants. Methods We designed and held DMEK wet lab courses using human donors and the simulation model and wet lab training for consultants. We collected surveys pre- and post- wet lab course attendance. We also recorded their performance times. We used human research grade corneas and Phillip DMEK, Kitaro model eye, artificial anterior chambers for consultants. Results All participants had practiced all the steps of DMEK and improved performance times. All reported to have increased confidence level as a direct result of the wet lab courses. All steps of DMEK surgery except graft manipulation were closely simulated to real-life surgery on patients. Out of the six consultants participating, two started DMEK services in their respective NHS trusts in the following month, with others planning to start DMEK services in the coming months. Conclusions The benefits of simulation and wet lab training is particularly valuable during the COVID-19 pandemic, which drastically reduced the availability of donor cornea, thus grinding to a halt corneal graft surgery nationally for many months. Surgeons, regardless of grade (beginner to advanced) can keep their skills up using wet lab and simulation. This setting also improves safety for patients.

12.
Revista Cubana de Salud Publica ; 48(2), 2022.
Article in Spanish | EMBASE | ID: covidwho-1965360

ABSTRACT

Introduction: In Santiago de Cuba province, the actions applied to control the epidemic in 2020 caused changes and negative effects on many of the health services that are usually provided in the territory. Objective: To identify the effect of the COVID-19 epidemic on health services in Santiago de Cuba province during 2020. Methods: A retrospective ecological study was conducted with time series as units of comparative analysis in Santiago de Cuba province as the only geographical territory to evaluate the effects of COVID-19 on the provision of health services during 2020. Some health service indicators from the time series from 2015 to 2019 were selected. The data source was official statistics. The percentage of change was estimated and a classification of the effects of COVID-19 according to its magnitude and meaning was proposed. Results: There were changes in the number and types of health services in terms of outpatient and emergency medical consultations, hospital admissions and average stay of cardiology activities related to admissions, coronary angiographies performed, pacemakers implanted and operations performed, elective surgical activities and emergency operations, as well as outpatient and minimal access ones, rehabilitative treatments, studies for diagnosis through the use of clinical and microbiology laboratories, imaging studies in general, and the most affected were those related to Stomatology, and kidney and corneal transplants. Conclusions: The COVID-19 epidemic had a negative effect on the functioning of health services as there were unfavorable changes in the number of services provided at the primary and secondary care levels, which can impact on the health of vulnerable people if alternative strategies are not established.

13.
Semin Ophthalmol ; : 1-7, 2022 Jul 05.
Article in English | MEDLINE | ID: covidwho-1927180

ABSTRACT

PURPOSE: Donor-related infections are a serious threat to patient safety after corneal transplantation. We provide a concise review of literature from the last decade on donor-related graft infections, sources of contamination and means to reduce the contamination of donor tissue and preservation media. METHODS: We reviewed 50 papers from year 2005 to 2021 related to donor-related graft infections. We included 14 studies related to the risk factors associated with post-keratoplasty infection and preventive methods. RESULTS: Incidence of post-keratoplasty infections has been reported to be approximately 0.2%-0.77% for endophthalmitis and 6.5%-10.5% for microbial keratitis. We analyzed six important studies regarding the risk factors related to donor contamination. It was observed that younger donor age, increased death to retrieval time, warming cycles and increased eye bank processing time and positive corneo-scleral rim cultures were important risk factors for donor-related infections post keratoplasty. Eye banks have adapted newer protocols over the time period for prevention of donor-related contamination. Recommended preventive strategies were published in about eight important studies over the past decade. In addition to meticulous donor screening, rapid warming cycles, double contact with povidone iodine during retrieval and addition of antifungals like amphotericin B, Voriconazole and cycloheximide have been suggested over the last decade although their use is still in debate with regard to the efficacy, toxicity and cost-effectiveness. CONCLUSION: The last decade has witnessed a relative rise of fungal infections and multidrug resistant bacterial infections post-keratoplasty. Eye bank prepared corneas for lamellar surgeries are at increased risk for donor contamination due to increased exposure to the higher temperatures during their processing. Addition of antifungals and broad spectrum antibiotics to the hypothermic preservation media needs to be considered in the new era of increasing trends of lamellar keratoplasty.

14.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925175

ABSTRACT

Objective: To report an atypical presentation of Lance-Adams Syndrome presenting from severe respiratory depression rather than cardiac arrest and to highlight the importance of distinguishing it from post hypoxic myoclonic variants. Background: Clinicians often face difficulty distinguishing Lance-Adams Syndrome (LAS) from Myoclonic Status Epilepticus (MSE). Similarities between the two conditions frequently result in confusion when diagnosing, managing and prognosticating for post-hypoxic myoclonus patients. Design/Methods: A 23-year-old male with a history pertinent for Hemophilia B, depression, opiate and alcohol abuse and chronic pain was found down in his home next to an empty bottle of clonazepam. He was hypoxic with oxygen saturation in the 40s and intubated in the field. Upon arrival to the Emergency room, neurological examination revealed intact corneal reflexes but no gag reflex, cough, or purposeful movements of the extremities. The patient exhibited stimulus induced myoclonic jerking which lasted >30 minutes despite being loaded on valproic acid and levetiracetam. Jerking subsequently ceased with propofol drip. Chest X-ray confirmed interstitial opacities and tested positive for SARS-CoV-2. On attempting to wean sedation, patient exhibited full-body myoclonus including face and palate with inability to follow commands and lack of spontaneous movements. As the EEG showed BIPEDS greater than 2.5 HZ, we decided to burst suppress him and treat with targeted temperature management. After 10 days, the patient was successfully weaned from sedation and extubated, but remained on multiple anti-seizure medications. Results: Patient responded well despite his diffuse cerebral anoxic injury. He regained the ability to follow commands upon discharge but had residual moderate expressive aphasia and post-hypoxic action-induced myoclonus, consistent with LAS. Conclusions: The atypical presentation of this case emphasizes the importance of distinguishing LAS from MSE to guide neurologists to aggressively treat LAS to improve outcome, particularly since MSE historically results with a 90-100% mortality rate.

15.
Med Arch ; 76(2): 146-148, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1924543

ABSTRACT

Background: Ocular herpes simplex is usually caused by herpes simplex virus type 1 (HSV-1) and less commonly by the type 2 virus (HSV-2). Ocular manifestations of HSV include blepharitis, conjunctivitis, lacrimal system obstruction, corneal involvement, and uveitis. Corneal involvement is one of the causes of loss of vision and can be epithelial herpetic keratitis or stromal herpetic keratitis. Objective: A significant population has a colonization of herpes viruses. Under certain circumstances, these viruses can reactivate with a significant ocular morbidity. Globally, COVID-19 vaccines are recommended; however, the vaccine safety data are limited. Case report: Herein, we reported a case of herpetic keratitis reactivation that occurred 2 days after receiving SARS-CoV-2 mRNA vaccine. The patient is a 50-year-old man who underwent penetrating keratoplasty (PKP) in 2020 for corneal opacity caused by a previous herpes simplex keratitis in 2013. Herpetic keratitis was treated successfully with topical antiviral acyclovir along with topical moxifloxacin and artificial tears. After treatment, prophylactic oral acyclovir was started. Conclusion: Both ophthalmologist and patients should be aware of this phenomenon. Long-term prophylactic antiviral treatment may be recommended for those patients.


Subject(s)
COVID-19 , Keratitis, Herpetic , Acyclovir/therapeutic use , Antiviral Agents/therapeutic use , COVID-19 Vaccines/adverse effects , Humans , Keratitis, Herpetic/drug therapy , Keratitis, Herpetic/etiology , Keratitis, Herpetic/prevention & control , Male , Middle Aged , RNA, Messenger , Recurrence , SARS-CoV-2 , Vaccination , Vaccines, Synthetic , mRNA Vaccines
16.
Italian Journal of Medicine ; 16(SUPPL 1):20, 2022.
Article in English | EMBASE | ID: covidwho-1913257

ABSTRACT

Introduction: Thromboembolism is a known phenomenon of coronavirus disease. Patients hospitalized with severe covid-19 demonstrate clinical and laboratory markers compatible with hypercoagulability. Case Report: A 85-old-man with a previous history of hypertension and diabetes. He presented to emergency room afebrile, oriented, cooperative (CGS 15), with cough, dyspnea and hypoxemia (oxygen saturation 88% on room air) requiring non-invasive-ventilation (C-PAP Fi O2 50% PEEP 5). Vital signs were: BP 100/70 mmHg, HR 88 bpm, RR 26/min;ECG: no arrhythmia;PCR for Sars- CoV2 was positive;the ChestX-Ray revealed bilateral consolidations. Laboratory findings at admission: WBC 10.4 K/microL, Neutrophils 9.7 K/microL, Lymphocytes 0,5 K/microL, Platelet Count 306 mm3, D-Dimer 703 ng/ml, CRP 158 mg/L. The patient started therapy with Piperacillin/Tazobactam, LMWH, steroids in addition to standard supportive care and admitted in covid department. On the second day he didn't respond to painful stimulations, neurological examination revealed bilateral babinski, left sides hemiplegia followed by absent corneal and vestibule-ocular reflexes (CGS 4);brain CT-Scan revealed acute large ischemic infarct. Laboratory findings after onset of stroke: WBC 17.6 K/microL, Neutrophils 16.4 K/microL, Lymphocytes 0,3 K/microL, Platelet Count 457 mm3, D-Dimers 7464 ng/ml, CRP 166 mg/L. Conclusions: Systemic inflammation and the potential direct action of the coronavirus may cause endothelial disfunction, resulting in a hypercoagulable state that could be considered a potential cause of ischemic stroke.

17.
Critical Reviews in Environmental Science and Technology ; 2022.
Article in English | EMBASE | ID: covidwho-1895682

ABSTRACT

Far UV-C, informally defined as electromagnetic radiation with wavelengths between 200 and 230 nm, has characteristics that are well-suited to control of airborne pathogens. Specifically, Far UV-C has been shown to be highly effective for inactivation of airborne pathogens;yet this same radiation has minimal potential to cause damage to human skin and eye tissues. Critically, unlike UV-B, Far UV-C radiation does not substantially penetrate the dead cell layer of skin (stratum corneum) and does not reach germinative cells in the basal layer. Similarly, Far UV-C radiation does not substantially penetrate through corneal epithelium of the eye, thereby preventing exposure of germinative cells within the eye. The most common source of Far UV-C radiation is the krypton chloride excimer (KrCl*) lamp, which has a primary emission centered at 222 nm. Ozone production from KrCl* lamps is modest, such that control of indoor ozone from these systems can be accomplished easily using conventional ventilation systems. This set of characteristics offers the potential for Far UV-C devices to be used in occupied spaces, thereby allowing for improved effectiveness for inactivation of airborne pathogens, including those that are responsible for COVID-19.

18.
J Clin Med ; 11(12)2022 Jun 09.
Article in English | MEDLINE | ID: covidwho-1884245

ABSTRACT

In the tissue donation field, to prevent pathogen transmission, all donors are screened by postmortem swabs for SARS-CoV-2 using qRT-PCR. Corneas from donors who tested positive for SARS-CoV-2 were subjected to further investigations. Corneal transplants and culture medium from positive donors were cultured under appropriate safety conditions for further analyses. Cornea tissue samples, including sclera/limbus/cornea, and culture media were taken at different time points for testing for SARS-CoV-2 using qRT-PCR, immunohistochemistry (IHC) and subgenomic RNA (sgRNA) analysis. Between January and May 2021, in four donors with initial negative premortem rapid tests, SARS-CoV-2 was detected post-mortem using qRT-PCR. In these cases, SARS-CoV-2 was observed at the beginning of cultivation in both tissue and culture medium using qRT-PCR and IHC. The virus was mainly localized in the limbus epithelial cells, with a stable detection level. Premortem rapid tests are potentially insufficient to exclude SARS-CoV-2 infection in corneal donors. While, for SARS-CoV-2, the risk of infection via transplants is considered low, a residual risk remains for presymptomatic new infections. However, our investigations provide the first indications that, with organ cultures, the risk of virus transmission is minimized due to the longer minimum culture period.

19.
BMJ Supportive & Palliative Care ; 12(Suppl 2):A12-A13, 2022.
Article in English | ProQuest Central | ID: covidwho-1874652

ABSTRACT

IntroductionNormalising the discussion and practice of Corneal Donation amongst hospice inpatients has been the focus of quality improvement (QI) work at the hospice for several years. Previous successful interventions include multi-professional education, developing a referral flow chart, alerts on the electronic patient record to flag potential donors and encouraging staff to observe the retrieval process. Prior to 2018, corneal donation was not routinely discussed and there was only one donation over 3 years compared to 211 referrals and 140 donors over the last 3 years. The COVID pandemic introduced unique challenges for corneal donation in the hospice, including reduced bed capacity, redeployed staff and tissue donation contraindicated in patients with recent COVID infection.Method(s)Routinely collected data of hospice deaths, including eligibility to be donors, evidence of discussions with patients and families and referral numbers were analysed comparing data during 2019–2020 with 2020–2021.ResultsIn April 2020-March 2021, 157 patients died at the hospice, which was just under half the number of deaths during April 2019-March 2020 (322), in keeping with the number of beds halved from 28 to 14. In 2020–2021 62% of patients were deemed eligible to donate, compared with 64% eligible during the preceding year. 82% of eligible patients were offered the opportunity to discuss tissue donation in 2020–2021, compared with 80% the previous year. There were 51 corneal donors at the hospice in 2019–2020 (24.6% of all considered eligible) compared to 25 donors in 2020–2021 (24.5% of those considered eligible).Conclusion(s)These results demonstrate that despite the numerous challenges of the pandemic, previously undertaken QI work has enabled sustained change, with the relative rate of tissue donation, frequency of discussions and subsequent referrals preserved during the pandemic period. QI is a fundamental tool for recovery from the pandemic and visualising future positive and sustained change.

20.
Eur J Ophthalmol ; 32(3): 1370-1374, 2022 May.
Article in English | MEDLINE | ID: covidwho-1868965

ABSTRACT

INTRODUCTION: To report the posterior corneal changes after Bowman Layer Transplant for keratoconus in a tertiary hospital in the UK. METHODS: 5 eyes of 5 patients receiving Bowman Layer Transplant for advanced keratoconus in Royal Gwent Hospital (Newport, UK) were included. Pre and postoperative posterior corneal astigmatism, posterior Kmean, and back surface elevation were analysed. RESULTS: No significant changes were seen in the posterior corneal astigmatism, posterior Kmean, or back surface elevation between the pre- and postoperative period. CONCLUSION: This results would support the idea that the corneal changes seen after Bowman Layer Transplant are mainly in the anterior corneal surface.


Subject(s)
Astigmatism , Keratoconus , Cornea , Corneal Topography/methods , Humans , Keratoconus/surgery , Refraction, Ocular , Visual Acuity
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