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Ocular Findings in COVID-19 Patients: A Review of Direct Manifestations and Indirect Effects on the Eye.
Bertoli, Federica; Veritti, Daniele; Danese, Carla; Samassa, Francesco; Sarao, Valentina; Rassu, Nicolò; Gambato, Tommaso; Lanzetta, Paolo.
  • Bertoli F; Department of Medicine-Ophthalmology, University of Udine, Udine, Italy.
  • Veritti D; Clinica Oculistica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
  • Danese C; Scientific Institute I.R.C.C.S. "Eugenio Medea"-"La Nostra Famiglia", Udine, Italy.
  • Samassa F; Department of Medicine-Ophthalmology, University of Udine, Udine, Italy.
  • Sarao V; Clinica Oculistica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
  • Rassu N; Department of Medicine-Ophthalmology, University of Udine, Udine, Italy.
  • Gambato T; Department of Medicine-Ophthalmology, University of Udine, Udine, Italy.
  • Lanzetta P; Department of Medicine-Ophthalmology, University of Udine, Udine, Italy.
J Ophthalmol ; 2020: 4827304, 2020.
Article in English | MEDLINE | ID: covidwho-788242
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Eye LOCATION_OF Globe finding
Subject
Eye
Predicate
LOCATION_OF
Object
Globe finding
3. Globe finding PROCESS_OF Patients
Subject
Globe finding
Predicate
PROCESS_OF
Object
Patients
4. 2019 novel coronavirus CAUSES COVID-19
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
COVID-19
5. Infected PROCESS_OF Patients
Subject
Infected
Predicate
PROCESS_OF
Object
Patients
6. Conjunctivitis COEXISTS_WITH COVID-19
Subject
Conjunctivitis
Predicate
COEXISTS_WITH
Object
COVID-19
7. anatomical layer LOCATION_OF Lesion
Subject
anatomical layer
Predicate
LOCATION_OF
Object
Lesion
8. Eye LOCATION_OF Complication
Subject
Eye
Predicate
LOCATION_OF
Object
Complication
9. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
10. Optic Neuropath PROCESS_OF C0030705
Subject
Optic Neuropath
Predicate
PROCESS_OF
Object
C0030705
11. Secondary Infections PROCESS_OF Patients
Subject
Secondary Infections
Predicate
PROCESS_OF
Object
Patients
12. Intraocular pressure disorder PROCESS_OF Patients
Subject
Intraocular pressure disorder
Predicate
PROCESS_OF
Object
Patients
13. Ocular surface disease PROCESS_OF Patients
Subject
Ocular surface disease
Predicate
PROCESS_OF
Object
Patients
14. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
15. Eye LOCATION_OF Globe finding
Subject
Eye
Predicate
LOCATION_OF
Object
Globe finding
16. Globe finding PROCESS_OF Patients
Subject
Globe finding
Predicate
PROCESS_OF
Object
Patients
17. 2019 novel coronavirus CAUSES COVID-19
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
COVID-19
18. Infected PROCESS_OF Patients
Subject
Infected
Predicate
PROCESS_OF
Object
Patients
19. Conjunctivitis COEXISTS_WITH COVID-19
Subject
Conjunctivitis
Predicate
COEXISTS_WITH
Object
COVID-19
20. anatomical layer LOCATION_OF Lesion
Subject
anatomical layer
Predicate
LOCATION_OF
Object
Lesion
21. Eye LOCATION_OF Complication
Subject
Eye
Predicate
LOCATION_OF
Object
Complication
22. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
23. Optic Neuropathy, Ischemic PROCESS_OF Patients
Subject
Optic Neuropathy, Ischemic
Predicate
PROCESS_OF
Object
Patients
24. Secondary Infections PROCESS_OF Patients
Subject
Secondary Infections
Predicate
PROCESS_OF
Object
Patients
25. Intraocular pressure disorder PROCESS_OF Patients
Subject
Intraocular pressure disorder
Predicate
PROCESS_OF
Object
Patients
26. Ocular surface disease PROCESS_OF Patients
Subject
Ocular surface disease
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
The novel pandemic coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has challenged the medical community. While diagnostic and therapeutic efforts have been focused on respiratory complications of the disease, several ocular implications have also emerged. SARS-CoV-2 RNA has been found in tears of the infected patients, and reports suggest that the ocular surface could serve as a portal of entry and a reservoir for viral transmission. Clinically, COVID-19 has been associated with mild conjunctivitis, which can be the first and only symptom of the disease. Subtle retinal changes like hyperreflective lesions in the inner layers on optical coherence tomography (OCT), cotton-wool spots, and microhemorrhages have also been reported. In addition, COVID-19 has been associated with an increased incidence of systemic diseases like diabetes mellitus and Kawasaki disease, which are particularly relevant for ophthalmologists due to their potentially severe ocular manifestations. Several treatment strategies are currently under investigation for COVID-19, but none of them have been proved to be safe and effective to date. Intensive care unit patients, due to risk factors like invasive mechanical ventilation, prone position, and multiresistant bacterial exposure, may develop ocular complications like ocular surface disorders, secondary infections, and less frequently acute ischemic optic neuropathy and intraocular pressure elevation. Among the array of drugs that have shown positive results, the use of hydroxychloroquine and chloroquine has raised a concern due to their well-known retinal toxic effects. However, the risk of retinal toxicity with short-term high-dose use of antimalarials is still unknown. Ocular side effects have also been reported with other investigational drugs like lopinavir-ritonavir, interferons, and interleukin-1 and interleukin-6 inhibitors. The aim of this review was to summarize ophthalmological implications of SARS-CoV-2 infection to serve as a reference for eye care and other physicians for prompt diagnosis and management.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Risk factors Language: English Journal: J Ophthalmol Year: 2020 Document Type: Article Affiliation country: 2020

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Risk factors Language: English Journal: J Ophthalmol Year: 2020 Document Type: Article Affiliation country: 2020