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1.
Retina ; 42(3): 465-475, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1706662

ABSTRACT

PURPOSE: To describe clinical and ophthalmologic features and outcomes of patients with coronavirus disease-19 with retinal vascular occlusions. METHODS: Retrospective multicenter case series and PubMed review of cases reported from March 2020 to September 2021. Outcome measures are as follows: type of occlusion, treatments, best-corrected visual acuity, and central macular thickness on optical coherence tomography. RESULTS: Thirty-nine patients were identified. Fifteen patients with a median age of 39 (30-67) years were included in the multicenter study. Vascular occlusions included central retinal vein occlusion (12 eyes), branch retinal vein occlusion (4 eyes), and central retinal artery occlusion (2 eyes). Three cases were bilateral. Baseline best-corrected visual acuity was 20/45 (no light perception-20/20). Baseline central macular thickness was 348.64 (±83) µm. Nine eyes received anti-vascular endothelial growth factor agents, dexamethasone intravitreal implant, or both. Final best-corrected visual acuity was 20/25 (no light perception-20/20), and central macular thickness was 273.7 ± 68 µm (follow-up of 19.6 ± 6 weeks). Among the 24 cases from the literature review, retinal vein occlusion was the predominant lesion. Clinical characteristics and outcomes were similar to those found in our series. CONCLUSION: Coronavirus disease-19-associated retinal vascular occlusions tend to occur in individuals younger than 60 years. Retinal vein occlusion is the most frequent occlusive event, and outcomes are favorable in most cases.


Subject(s)
COVID-19/diagnosis , Eye Infections, Viral/diagnosis , Retinal Vein Occlusion/diagnosis , SARS-CoV-2/isolation & purification , Adult , Aged , Angiogenesis Inhibitors/therapeutic use , COVID-19/drug therapy , COVID-19/virology , COVID-19 Nucleic Acid Testing , Dexamethasone/therapeutic use , Drug Implants , Eye Infections, Viral/drug therapy , Eye Infections, Viral/virology , Female , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Intravitreal Injections , Male , Middle Aged , Retinal Vein Occlusion/drug therapy , Retinal Vein Occlusion/virology , Retrospective Studies , SARS-CoV-2/genetics , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity/physiology
3.
Ocul Immunol Inflamm ; 29(6): 1225-1233, 2021 Aug 18.
Article in English | MEDLINE | ID: covidwho-1467232

ABSTRACT

The novel pandemic coronavirus disease 2019 (COVID-19) leading to health and economic problems worldwide is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although COVID-19 mainly occurs as a lower respiratory tract infection, there is multiorgan involvement in infected patients. The disease is transmitted from person to person through air droplets or contact with contaminated surfaces. SARS-CoV-2 leads to this systemic involvement by attaching to angiotensin-converting enzyme 2 (ACE2) receptors located on several human cells. Since SARS-CoV-2 RNA has been found in tears of infected patients, ocular surface may allow the virus to transmit to nasopharynx via the nasolacrimal duct. This narrative review aims to sum up all segmental ocular complications, ocular adverse effects of COVID-19 treatment, and preventive measures suggested to minimize the SARS-CoV-2 transmission between patients and ophthalmologists by reviewing currently available literature.


Subject(s)
COVID-19/diagnosis , Eye Infections, Viral/diagnosis , SARS-CoV-2 , Tears/virology , COVID-19/prevention & control , COVID-19/virology , COVID-19 Nucleic Acid Testing , Conjunctivitis, Viral/diagnosis , Conjunctivitis, Viral/prevention & control , Conjunctivitis, Viral/virology , Encephalitis, Viral/diagnosis , Encephalitis, Viral/prevention & control , Encephalitis, Viral/virology , Eye Infections, Viral/prevention & control , Eye Infections, Viral/virology , Humans , Preventive Medicine/methods , Retinal Diseases/diagnosis , Retinal Diseases/prevention & control , Retinal Diseases/virology , SARS-CoV-2/pathogenicity
4.
Cornea ; 40(9): 1204-1206, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-1343730

ABSTRACT

PURPOSE: The purpose of this study was to report 2 patients with anterior scleritis manifesting after coronavirus disease 2019 (COVID-19). METHODS: The patients with confirmed COVID-19 developed anterior scleritis after their systemic symptoms were markedly improved. A thorough systemic workup identified no underlying autoimmune diseases. Ocular characteristics and safety and efficacy of systemic immunosuppressive therapy were evaluated. RESULTS: Case 1 was a 67-year-old woman who presented with necrotizing anterior scleritis in both eyes 3 weeks after the onset of COVID-19. One-week treatment with topical betamethasone and oral prednisolone (65 mg daily) did not result in improvement, so she was started on intravenous cyclophosphamide and subcutaneous adalimumab in addition to oral prednisolone. Necrotizing scleritis was gradually improved over 3 months. Case 2 was a 33-year-old man who presented with sectoral anterior scleritis in his right eye 2 weeks after the onset of COVID-19. He was started on topical betamethasone and oral prednisolone (85 mg daily). One week later, all signs and symptoms disappeared, and topical and oral corticosteroids were gradually tapered off over 2 weeks. There was no recurrence of respiratory symptoms or active scleritis in any cases after discontinuation of treatment. CONCLUSIONS: These cases suggest that COVID-19 can be associated with anterior scleritis, which responds to immunosuppressive and biologic agents. Ophthalmologists should consider anterior scleritis in patients with COVID-19 who present with ocular pain and redness during the convalescent phase of the illness.


Subject(s)
COVID-19/diagnosis , Eye Infections, Viral/diagnosis , SARS-CoV-2/isolation & purification , Scleritis/diagnosis , Adalimumab/therapeutic use , Adult , Aged , Anti-Inflammatory Agents/therapeutic use , COVID-19/drug therapy , COVID-19/virology , COVID-19 Nucleic Acid Testing , Cyclophosphamide/therapeutic use , Eye Infections, Viral/drug therapy , Eye Infections, Viral/virology , Female , Humans , Immunosuppressive Agents/therapeutic use , Infusions, Intravenous , Infusions, Subcutaneous , Male , Prednisolone/therapeutic use , SARS-CoV-2/genetics , Scleritis/drug therapy , Scleritis/virology
5.
Cornea ; 40(11): 1502-1504, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1328949

ABSTRACT

ABSTRACT: The coronavirus disease 2019 global pandemic is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several ophthalmic manifestations have been reported to be associated with SARS-CoV-2 infection, including conjunctivitis, acute sixth nerve palsy, and multiple cranial neuropathies. We present a unique case of unilateral phlyctenular keratoconjunctivitis in a 5-year-old boy in the setting of SARS-CoV-2 infection.


Subject(s)
COVID-19/diagnosis , Conjunctivitis, Viral/diagnosis , Eye Infections, Viral/diagnosis , Keratoconjunctivitis/diagnosis , SARS-CoV-2/pathogenicity , Administration, Oral , Anti-Bacterial Agents/administration & dosage , Ascorbic Acid/administration & dosage , Azithromycin/administration & dosage , COVID-19/drug therapy , COVID-19/virology , COVID-19 Nucleic Acid Testing , Child, Preschool , Conjunctivitis, Viral/drug therapy , Conjunctivitis, Viral/virology , Drug Therapy, Combination , Eye Infections, Viral/drug therapy , Eye Infections, Viral/virology , Fluorometholone/therapeutic use , Glucocorticoids/therapeutic use , Humans , Keratoconjunctivitis/drug therapy , Keratoconjunctivitis/virology , Male , Ophthalmic Solutions , Slit Lamp Microscopy , Tomography, Optical Coherence , Visual Acuity/physiology
6.
Cornea ; 40(8): 1067-1069, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1303954

ABSTRACT

ABSTRACT: We present 2 cases of striking stromal corneal infiltrates months after COVID-19 infection. While we cannot prove that these infiltrates are caused by or directly related to COVID-19, we did not find any other plausible cause that could explain these ophthalmic signs. In these cases, the ongoing process was detected in relatively early stages due to scheduled visits with patients and responded positively to prednisolone acetate 1% ophthalmic suspension. However, we do not know the response to treatment in more advanced cases.


Subject(s)
COVID-19/diagnosis , Corneal Diseases/diagnosis , Corneal Stroma/pathology , Eye Infections, Viral/diagnosis , SARS-CoV-2 , COVID-19/drug therapy , COVID-19/virology , COVID-19 Nucleic Acid Testing , Corneal Diseases/drug therapy , Corneal Diseases/virology , Eye Infections, Viral/drug therapy , Eye Infections, Viral/virology , Female , Glaucoma, Open-Angle/diagnosis , Glucocorticoids/therapeutic use , Humans , Immune Complex Diseases/diagnosis , Immune Complex Diseases/drug therapy , Immune Complex Diseases/virology , Male , Middle Aged , Prednisolone/therapeutic use , SARS-CoV-2/immunology , Uveitis/diagnosis
7.
Ocul Immunol Inflamm ; 29(4): 666-668, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1303841

ABSTRACT

Purpose: To evaluate and establishe the number of patients with ocular manifestations in the early phase of systemic COVID-19 infection.Methods: A cross-sectional study was performed in a COVID-19 referral center regarding ocular findings in patients with COVID-19 in the first few days of the disease. The patients were submitted to a clinical examination, an ophthalmic exam and a RT-PCR for SARS-COV-2.Results: Out of 1740 patients, we reported 108 patients with ocular manifestations. Forty-nine with markedly conjunctivitis had conjunctival swab positive for SARS-COV-2, four of them developed keratitis. There were mostly no evidence of retinopathy nor decrease in visual acuity. They had no marked clinical symptoms, which can contribute and demonstrate that the virus may cause ocular disease as an only finding or in the very early stage of the infection.Conclusion: Patients were in the first days of COVID-19 infection, presented ocular manifestations suggested to be related to the virus and need to be aware of the pathways of transmissions.


Subject(s)
COVID-19/complications , Conjunctiva/pathology , Conjunctivitis, Viral/diagnosis , Eye Infections, Viral/diagnosis , RNA, Viral/analysis , SARS-CoV-2/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , COVID-19/epidemiology , COVID-19/virology , Conjunctiva/virology , Conjunctivitis, Viral/etiology , Conjunctivitis, Viral/virology , Cross-Sectional Studies , Eye Infections, Viral/etiology , Eye Infections, Viral/virology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pandemics , Time Factors , Young Adult
8.
Ocul Immunol Inflamm ; 29(4): 722-725, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1297343

ABSTRACT

Purpose: Infection by the SARS-CoV2 virus results in an immune dysregulated state which can predispose to reactivation of Herpes viruses. This report describes the development of Acute Retinal Necrosis (ARN) in two patients who had recovered from SARS-CoV2 infection.Methods: Observational report of two consecutive patients who presented with ARN after having recovered from SARS-CoV-2 infection.Results: Case 1 was a 5-year-old child with extensive peripheral necrotizing retinitis. Case 2 was a 61-year-old gentlemen with bilateral retinal detachment with sieve-like breaks and optic atrophy. Both patients had recovered from SARS- Cov-2 infection 1 month ago. PCR from vitreous sample of both patients was positive for Herpes simplex virus. Case 1 was treated with oral valacyclovir. Case 2 underwent surgery in both eyes for retinal detachmentConclusion: Immune dysregulation after COVID-19 infection can result in reactivation of herpesvirus and may lead to development of ARN.


Subject(s)
COVID-19/complications , Eye Infections, Viral/etiology , Retinal Necrosis Syndrome, Acute/etiology , SARS-CoV-2/genetics , Visual Acuity , COVID-19/virology , Child, Preschool , Eye Infections, Viral/diagnosis , Humans , Male , Middle Aged , RNA, Viral/analysis , Retinal Necrosis Syndrome, Acute/diagnosis
10.
Ocul Immunol Inflamm ; 29(4): 652-655, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1216508

ABSTRACT

Purpose: To evaluate the presence of SARS-CoV-2 in conjunctival secretions of COVID-19 patients.Material and Methods: In this retrospective study, the records were examined of patients who were treated in the hospital with the diagnosis of COVID-19 between March-May 2020 and were referred to the eye clinic due to ocular symptoms. Conjunctival swabs from both confirmed and suspected COVID-19 cases during hospitalization were analyzed.Results: A total of 35 patients (22 suspected, 13 laboratory-confirmed COVID-19) were referred to the eye clinic. Conjunctival swab samples from 3 patients yielded positive PCR results. These three patients were being treated in the intensive care unit, and all were suspected COVID-19 patients.Conclusion: SARS-CoV-2 may be detected in patients with suspected COVID-19. Even with conjunctivitis findings, SARS-CoV-2 may not be detected in most conjunctiva swab samples of COVID-19 patients.


Subject(s)
COVID-19/virology , Conjunctiva/metabolism , Conjunctivitis, Viral/diagnosis , Eye Infections, Viral/diagnosis , Adult , Aged , COVID-19/metabolism , Conjunctiva/pathology , Conjunctiva/virology , Conjunctivitis, Viral/metabolism , Conjunctivitis, Viral/virology , Eye Infections, Viral/metabolism , Eye Infections, Viral/virology , Female , Humans , Male , Middle Aged , RNA, Viral/analysis , Retrospective Studies , SARS-CoV-2/genetics , Specimen Handling
11.
Ocul Immunol Inflamm ; 29(4): 700-704, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1185531

ABSTRACT

Purpose: To report bilateral anterior uveitis and corneal punctate epitheliopathy in children with multisystem inflammatory syndrome (MIS-C) secondary to coronavirus disease (COVID-19).Participants and methods: Five patients who were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies and diagnosed with MIS-C were evaluated. Ophthalmologic examinations were performed in order to reveal ocular findings in MIS-C disease.Results: Slit lamp examinations showed bilateral non-granulomatous acute anterior uveitis in all patients and severe corneal punctuate epitheliopathy in three of the patients. These ocular findings mostly disappeared with treatment in about one week.Conclusion: Bilateral non-granulomatous acute anterior uveitis and dry eye can be detected in patients diagnosed with MIS-C secondary to COVID-19. Even if generally, COVID-19 is not a life threatening disease in children by itself, inflammatory ocular manifestations can be detected in MIS-C secondary to COVID-19.


Subject(s)
Antibodies, Viral/analysis , COVID-19/complications , Cornea/pathology , Corneal Diseases/etiology , Eye Infections, Viral/etiology , SARS-CoV-2/immunology , Systemic Inflammatory Response Syndrome/complications , Uveitis, Anterior/etiology , Adolescent , COVID-19/diagnosis , COVID-19/virology , Child , Cornea/virology , Corneal Diseases/diagnosis , Corneal Diseases/virology , Eye Infections, Viral/diagnosis , Eye Infections, Viral/virology , Female , Humans , Male , Severity of Illness Index , Slit Lamp Microscopy , Systemic Inflammatory Response Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/virology , Uvea/pathology , Uvea/virology , Uveitis, Anterior/diagnosis , Uveitis, Anterior/virology
12.
Ocul Immunol Inflamm ; 29(4): 677-680, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1172599

ABSTRACT

Purpose: Herein, we report a case of bilateral neuroretinitis and panuveitis in a patient recovered from coronavirus disease 2019 (COVID-19).Case presentation: A 37-year-old male patient with a history of recovered COVID-19, which was confirmed with nasopharyngeal reverse transcriptase polymerase chain reaction (RT-PCR) for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), about one-month ago was referred with one-week history of bilateral severe vision loss. Visual acuity was counting fingers, and bilateral retinitis and panuveitis were revealed in ocular examination. The result of the vitreous sample using RT-PCR was positive for SARS-CoV-2 and negative for Herpesviridae viruses and mycobacterium tuberculosis. The patient was successfully treated with corticosteroid.Conclusion: We report a case of bilateral neuroretinitis and panuveitisin a recovered COVID-19 patient and positive RT-PCR of the vitreous sample. It is suggested to apply intraocular sampling and evaluation for COVID-19 in patients with the new-onset of uveitis and/or retinitis during the pandemic.


Subject(s)
COVID-19/complications , Eye Infections, Viral/etiology , Panuveitis/etiology , RNA, Viral/analysis , Retinitis/etiology , SARS-CoV-2/genetics , Visual Acuity , Adult , COVID-19/epidemiology , Eye Infections, Viral/diagnosis , Eye Infections, Viral/virology , Fluorescein Angiography/methods , Fundus Oculi , Humans , Male , Pandemics , Panuveitis/diagnosis , Panuveitis/virology , Retina/pathology , Retinitis/diagnosis , Retinitis/virology , Tomography, Optical Coherence/methods , Uvea/pathology
13.
Ocul Immunol Inflamm ; 29(4): 684-689, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1171739

ABSTRACT

Purpose: To summarize ophthalmic manifestations of coronavirus disease (COVID-19) reported in the literature thus far.Methods: The PubMed database was systematically searched through October 24, 2020, to identify relevant articles using the following search terms: ("COVID-19" OR "SARS-CoV-2") AND ("eye" OR "ophthalmology" OR "retina" OR "retinal findings" OR "cornea" OR "conjunctiva"). Only articles published in English were included in this review.Results: The reported prevalence of ophthalmic manifestations is generally low, but correlates positively with the severity of the disease. Most commonly reported ocular manifestations are conjunctivitis, conjunctival hyperemia and chemosis. Retinal findings include microhemorrhages and flame-shaped hemorrhages, cotton wool spots, dilated veins, and tortuous vessels.Conclusion: Considering the COVID-19 cases have reached pandemic dimensions and are surging, yet again, it is of utmost importance to determine its ophthalmic manifestations and prevent their vision threatening complications. Further studies are warranted to establish whether the retinal findings appear due to the COVID-19 or are an incidental finding in patients with a preexisting diabetic or hypertensive retinopathy.


Subject(s)
COVID-19/complications , Conjunctiva/virology , Conjunctivitis/virology , Eye Infections, Viral/virology , SARS-CoV-2/genetics , COVID-19/virology , Conjunctiva/diagnostic imaging , Conjunctivitis/diagnosis , Conjunctivitis/etiology , Eye Infections, Viral/diagnosis , Eye Infections, Viral/etiology , Humans , Pandemics
14.
Ocul Immunol Inflamm ; 29(4): 681-683, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1171738

ABSTRACT

Purpose: To present a a case study that aims to investigate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the ocular tissue samples of a patient previously infected with COVID-19 and determine its transmissibility.Study Design: Case ReportResults: In this case study, SARS-CoV-2 was not detected in the vitreous and uveal tissue samples by RT-PCR for detection of three gene targets in a patient with a past COVID-19 infection 15 days prior to presention with a globe rupture.Conclusions: Our findings suggest that patients with long-term existence of SARS-CoV-2 at low detectable levels may not have active intraocular viral shedding. This is of particular importance as ophthalmic surgical procedures may potentiate virus spread from patients infected with SARS-CoV-2.


Subject(s)
COVID-19/virology , Eye Infections, Viral/diagnosis , RNA, Viral/analysis , SARS-CoV-2/genetics , Uvea/virology , Vitreous Body/virology , Adult , COVID-19/complications , COVID-19/diagnosis , Eye Infections, Viral/etiology , Eye Infections, Viral/virology , Female , Humans , Specimen Handling , Virus Shedding
15.
JAMA Ophthalmol ; 139(7): 777-780, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1171509

ABSTRACT

IMPORTANCE: Congenital viral infections leading to ocular abnormalities are frequent and devastating. As ophthalmological manifestations of COVID-19 in newborns are still unknown, it is important to clarify if SARS-CoV-2 could be associated with ocular abnormalities. OBJECTIVE: To determine whether exposure to SARS-CoV-2 is associated with outcomes in the eyes of newborns. DESIGN, SETTING, AND PARTICIPANTS: This case series enrolled newborns from April to November 2020 from 3 different maternity hospitals in São Paulo, Brazil. The diagnosis of COVID-19 in mothers and newborns was based on real-time reverse transcriptase-polymerase chain reaction assays with material obtained from oronasopharyngeal swab sample; positive IGM serology was also considered as a diagnostic test for mothers. Newborns were excluded if they had any evidence of another congenital infection. All infants underwent external ocular examination and binocular indirect ophthalmoscopy. EXPOSURES: Serology test for COVID-19 and detection of SARS-CoV-2 from oronasopharyngeal specimen using a real-time reverse transcriptase-polymerase chain reaction assay on both mothers and newborns. MAIN OUTCOMES AND MEASURES: Screening for ophthalmologic manifestation in newborns after maternal COVID-19 infection. RESULTS: A total of 165 newborns (age range at examination, 1 to 18 days) were evaluated. Of these, 123 (74.5%) were born at full term, and 42 (25.4%) were born preterm. Maternal gestational age at the time of COVID-19-positive test varied from first to 40th gestational weeks. Six newborns (3.6%) had positive polymerase chain reaction findings for SARS-CoV-2. One newborn tested positive within 18 days (horizontal transmission), and 5 newborns tested positive in the first day of life (possible vertical transmission). None had ocular abnormalities. Concerning exposed newborns with negative test results, 1 presented with venous engorgement and vascular tortuosity, 7 had intraretinal hemorrhages, and 2 were diagnosed as having retinopathy of prematurity. CONCLUSIONS AND RELEVANCE: In this uncontrolled case series of Brazilian newborns of mothers with COVID-19 infection, a low rate of COVID-19 infection was found among newborns, and none had ocular abnormalities. Additional controlled studies may be warranted to confirm these findings.


Subject(s)
COVID-19/virology , Eye Infections, Viral/virology , Eye/virology , Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious/virology , Prenatal Exposure Delayed Effects , Brazil , COVID-19/diagnosis , COVID-19/transmission , COVID-19 Testing , Diagnostic Techniques, Ophthalmological , Eye Infections, Viral/diagnosis , Eye Infections, Viral/transmission , Female , Gestational Age , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Complications, Infectious/diagnosis
16.
Ocul Immunol Inflamm ; 29(4): 669-670, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1165118

ABSTRACT

Purpose: The authors present a case of unilateral orbital myositis of new onset following COVID-19 without a severe course.Methods: The patient had been received topical treatment with a preliminary diagnosis of conjunctivitis but no recovery had been noticed. The history revealed that the ocular signs had started 1 week after the COVID-19.Results: The examination revealed sectoral hyperemia of the temporal region in the bulbar conjunctiva together with marked limitation of right inward gaze. MRI of the orbits demonstrated diffuse fusiform enhancing enlargement of the right lateral rectus and superior rectus. The results of the laboratory tests and examination findings were normal. Systemic corticosteroids were started for the orbital myositis.Conclusions: Although conjunctivitis is the more common ocular disease following COVID-19, the possibility of orbital myositis should be considered in cases with resistance to topical treatment and/or gaze limitation. The possible role of orbital myositis as a trigger for COVID-19 could be explained with an immune-mediated mechanism.


Subject(s)
COVID-19/complications , Eye Infections, Viral/diagnosis , Oculomotor Muscles/diagnostic imaging , Orbit/diagnostic imaging , Orbital Myositis/etiology , SARS-CoV-2/genetics , Adult , COVID-19/diagnosis , COVID-19/epidemiology , Eye Infections, Viral/etiology , Eye Infections, Viral/virology , Female , Humans , Magnetic Resonance Imaging , Oculomotor Muscles/virology , Orbital Myositis/diagnosis , Orbital Myositis/virology , Pandemics , Tomography, X-Ray Computed
17.
Ocul Immunol Inflamm ; 29(4): 662-665, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1165117

ABSTRACT

Purpose: To firstly present management of toxic anterior segment syndrome (TASS) and possible postoperative endophthalmitis (POE) after implantation of a new hydrophilic-acrylic posterior chamber (PC) phakic intraocular lens (pIOL) in a case with undeclared history of COVID-19.Methods: A 21-year-old male without known disease represented severe anterior chamber inflammation (hypopyon), poor vision and corneal edema without vitreous involvement (TASS) at 24-hours after PC-pIOL implantation for unilateral high myopia (amblyopic).Results: Preoperative best-corrected visual acuity (BCVA) was 0.2 OS (-13 diopters). At 56-hours, vitreous was involved with visual loss indicating POE. The patient confessed that he had COVID-19 1-month ago. COVID-19 immunoglobulin M/G tests were positive, while other markers were negative. Intracameral/intravitreal antibiotics were applied. BCVA was 0.15 without hypopyon at 24-hours. Cultures were negative. Final BCVA was 0.6 with normal examination.Conclusion: TASS/POE etiology could not be demonstrated in this case, whereas COVID-19-related proinflammatory systemic background could have effect on triggering/aggravating this scenario.].


Subject(s)
COVID-19/epidemiology , Endophthalmitis/etiology , Eye Infections, Viral/etiology , Myopia/surgery , Phakic Intraocular Lenses/adverse effects , SARS-CoV-2/genetics , Surgical Wound Infection/etiology , Anterior Eye Segment/diagnostic imaging , Anterior Eye Segment/virology , Comorbidity , Endophthalmitis/diagnosis , Endophthalmitis/virology , Eye Infections, Viral/diagnosis , Eye Infections, Viral/virology , Humans , Lens Implantation, Intraocular , Male , Myopia/epidemiology , RNA, Viral/analysis , Surgical Wound Infection/diagnosis , Surgical Wound Infection/virology , Young Adult
18.
Eye Contact Lens ; 47(4): 168-173, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1140027

ABSTRACT

PURPOSE: To assess the effect of severe acute respiratory syndrome coronavirus-2 infection on the conjunctiva and tear film. METHODS: Thirty-eight patients with confirmed COVID-19 and 31 healthy controls were included in this prospective and observational study. Individuals with COVID-19 formed the patient group, and healthy individuals formed the control group. Conjunctival impression cytology (CIC), TBUT, Schirmer II test, and ocular surface disease index were evaluated in all participants. RESULTS: No significant difference was observed regarding the mean age and gender between the groups (P=0.786 and P=0.122, respectively). The mean TBUT and Schirmer II test results did not differ between the two groups (P=0.496 and P=0.447, respectively). The CIC results revealed decreased density and cell size of goblet cells and moderate to high enlargement, squamous changes, and increased nucleocytoplasmic ratio in nongoblet epithelial cells in the COVID-19 group compared with the control group. Based on the Nelson classification in CIC samples, 60.6% of the COVID-19 group and 19.4% of the control group had changes consistent with grade 2 or above. The presence of neutrophils in CIC was significantly higher in the COVID-19 group (P<0.001), whereas the presence of lymphocyte was similar between the two groups (P=0.247). CONCLUSION: This study revealed the pathological conjunctival alterations in patients with COVID-19 and demonstrated that pathological ocular surface alterations may present even at the beginning of COVID-19 without clinically significant ocular manifestation.


Subject(s)
COVID-19/diagnosis , Conjunctiva/pathology , Conjunctivitis, Viral/diagnosis , Dry Eye Syndromes/diagnosis , Eye Infections, Viral/diagnosis , SARS-CoV-2/isolation & purification , Tears/virology , Adult , COVID-19 Nucleic Acid Testing , Cell Count , Cell Size , Conjunctivitis, Viral/virology , Cross-Sectional Studies , Cytological Techniques , Dry Eye Syndromes/virology , Eye Infections, Viral/virology , Female , Goblet Cells/pathology , Humans , Lymphocytes/pathology , Male , Middle Aged , Neutrophils/pathology , Prospective Studies , SARS-CoV-2/genetics , Young Adult
19.
Ocul Immunol Inflamm ; 29(4): 656-661, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1139809

ABSTRACT

Introduction: The Ocular manifestations of coronavirus disease 2019 (COVID-19) reported include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, episcleritis, retinal manifestations included cotton wool spots (CWS), micro-hemorrhages, papillophlebitis and neuro-ophthalmic manifestations.Purpose: To report post COVID-19 ophthalmic manifestations using multimodal imaging.Results: A 66-year-old Asian Indian male presented to us with bilateral blurring of vision, RE>LE, of 3 days following a diagnosis of COVID-19 disease. Corrected distance visual acuity were 20/2666 and 20/25 in the right (RE) and left (LE) eyes respectively. He had bilateral anterior chamber inflammation with a relative afferent pupillary defect in the RE. RE showed central retinal artery occlusion(CRAO) with CWS, few flame-shaped retinal hemorrhages and disc edema and hyperemia. LE had disc edema and hyperemia, few flame-shaped retinal hemorrhages, cystoid changes and CWS. A diagnosis of bilateral panuveitis and papillitis with CRAO in the RE was made.Conclusion: Our patient developed a vascular occlusion with panuveitis, which possibly represents an immune mediated event following COVID-19. Patients should be warned about possible ophthalmic sequelae even after recovery.


Subject(s)
COVID-19/complications , Eye Infections, Viral/etiology , Fluorescein Angiography/methods , Optic Disk/pathology , Optic Neuritis/etiology , Panuveitis/etiology , RNA, Viral/analysis , SARS-CoV-2/genetics , Aged , COVID-19/ethnology , Eye Infections, Viral/diagnosis , Eye Infections, Viral/virology , Fundus Oculi , Humans , India/epidemiology , Male , Optic Neuritis/diagnosis , Optic Neuritis/virology , Panuveitis/diagnosis , Panuveitis/virology , Tomography, Optical Coherence/methods
20.
Indian J Ophthalmol ; 69(4): 985-986, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1138826

ABSTRACT

A 32-year-old man with a clear and compact graft following a penetrating keratoplasty 6 years back, developed an episode of acute graft rejection, coinciding with the COVID-19 disease. Subsequent to the infection with the novel coronavirus, he developed symptoms of acute graft rejection concurrent with the development of respiratory distress and peak systemic symptoms. This was the phase of cytokine storm as evidenced by the raised inflammatory markers in his blood tests. Such a case of acute corneal graft rejection coinciding with SARS-CoV-2 infection has been reported only once in the literature and this unique association needs to be researched further.


Subject(s)
COVID-19/diagnosis , Corneal Diseases/diagnosis , Eye Infections, Viral/diagnosis , Graft Rejection/diagnosis , Keratoplasty, Penetrating , SARS-CoV-2 , Acute Disease , Adult , COVID-19/drug therapy , COVID-19/virology , COVID-19 Nucleic Acid Testing , Cataract Extraction , Corneal Diseases/drug therapy , Corneal Diseases/virology , Cytokines/blood , Eye Infections, Viral/drug therapy , Eye Infections, Viral/virology , Glucocorticoids/therapeutic use , Graft Rejection/drug therapy , Graft Rejection/virology , Humans , Incidence , Inflammation Mediators/blood , Lens Implantation, Intraocular , Male , Pneumonia, Viral/blood , Prednisolone/therapeutic use , Visual Acuity
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