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Small fiber neuropathy in the cornea of Covid-19 patients associated with the generation of ocular surface disease.
Barros, Alberto; Queiruga-Piñeiro, Juan; Lozano-Sanroma, Javier; Alcalde, Ignacio; Gallar, Juana; Fernández-Vega Cueto, Luis; Alfonso, José F; Quirós, Luis M; Merayo-Lloves, Jesús.
  • Barros A; Instituto Oftalmológico Fernández-Vega, Oviedo, Spain.
  • Queiruga-Piñeiro J; Instituto Oftalmológico Fernández-Vega, Oviedo, Spain.
  • Lozano-Sanroma J; Instituto Oftalmológico Fernández-Vega, Oviedo, Spain.
  • Alcalde I; Instituto Universitario Fernández-Vega, Universidad de Oviedo & Fundación de Investigación Oftalmológica, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. Electronic address: nacho.alcalde@fio.as.
  • Gallar J; Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain.
  • Fernández-Vega Cueto L; Instituto Oftalmológico Fernández-Vega, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. Electronic address: lfvc@fernandez-vega.com.
  • Alfonso JF; Instituto Oftalmológico Fernández-Vega, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Surgery and Medical-Surgical Specialties, Universidad de Oviedo, Oviedo, Spain.
  • Quirós LM; Instituto Universitario Fernández-Vega, Universidad de Oviedo & Fundación de Investigación Oftalmológica, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain.
  • Merayo-Lloves J; Instituto Oftalmológico Fernández-Vega, Oviedo, Spain; Instituto Universitario Fernández-Vega, Universidad de Oviedo & Fundación de Investigación Oftalmológica, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Surgery and Medical
Ocul Surf ; 23: 40-48, 2022 01.
Article in English | MEDLINE | ID: covidwho-1573810
ABSTRACT

PURPOSE:

To describe the association between Sars-CoV-2 infection and small fiber neuropathy in the cornea identified by in vivo corneal confocal microscopy.

METHODS:

Twenty-three patients who had overcome COVID-19 were recruited to this observational retrospective study. Forty-six uninfected volunteers were also recruited and studied as a control group. All subjects were examined under in vivo confocal microscopy to obtain images of corneal subbasal nerve fibers in order to study the presence of neuroma-like structures, axonal beadings and dendritic cells. The Ocular Surface Disease Index (OSDI) questionnaire and Schirmer tear test were used as indicators of Dry Eye Disease (DED) and ocular surface pathology.

RESULTS:

Twenty-one patients (91.31%) presented alterations of the corneal subbasal plexus and corneal tissue consistent with small fiber neuropathy. Images from healthy subjects did not indicate significant nerve fiber or corneal tissue damage. Eight patients reported increased sensations of ocular dryness after COVID-19 infection and had positive DED indicators. Beaded axons were found in 82.60% of cases, mainly in patients reporting ocular irritation symptoms. Neuroma-like images were found in 65.22% patients, more frequently in those with OSDI scores >13. Dendritic cells were found in 69.56% of patients and were more frequent in younger asymptomatic patients. The presence of morphological alterations in patients up to 10 months after recovering from Sars-CoV-2 infection points to the chronic nature of the neuropathy.

CONCLUSIONS:

Sars-CoV-2 infection may be inducing small fiber neuropathy in the ocular surface, sharing symptomatology and morphological landmarks with DED and diabetic neuropathy.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dry Eye Syndromes / Small Fiber Neuropathy / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Ocul Surf Year: 2022 Document Type: Article Affiliation country: J.jtos.2021.10.010

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dry Eye Syndromes / Small Fiber Neuropathy / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Ocul Surf Year: 2022 Document Type: Article Affiliation country: J.jtos.2021.10.010