ABSTRACT
PURPOSE: To investigate if symptomatic conjunctivitis during the recovery phase of the disease could be associated to a persistent presence of SARS-CoV-2 in the upper respiratory tract. Secondary end points were to analyze the presence of SARS-CoV-2 in the conjunctiva of ocular symptomatic patients and to record the presence of ocular disturbances at this point of the disease. METHODS: An observational study including consecutive COVID19 patients treated at Humanitas Clinical and Research Hospital who were attending for nasopharyngeal swab to confirm the resolution of SARS-CoV-2 infection and end of isolation. We examined 129 consecutive patients from May to June 2020. The primary end point was to determine if symptomatic conjunctivitis at this point of the disease could be associated to a persistent presence of SARS-CoV-2 in the upper respiratory tract. Secondary end points were to analyze the presence of SARS-CoV-2 in the conjunctiva of ocular symptomatic patients and to record the presence of ocular disturbances at this point of the disease. RESULTS: One hundred twenty eight patients were included, 9.38% had conjunctivitis, none resulted positive to conjunctival PCR swab test, while two of them had positive nasopharyngeal result. Mean time elapsed since the first COVID-19 positive swab to the time of examination was 6 weeks ( ± 3). The only significant association was the presence of conjunctivitis with older age (65.3 ± 12.7 vs 56.7 + 13.5. p = 0.046). Nasopharyngeal swab resulted positive in 22 patients (17.19%). While 88 patients (68.2%) did not have any ocular complain during their COVID19 disease. The 40 patients (31.8%) reporting ocular disturbances complained about: redness (25.43%), tearing (19.53%), burning (18.35%), foreign body sensation (17.18%), itching (15.62%), and discharge (12.5%). CONCLUSION: This study showed that late conjunctivitis cannot be considered as a marker of persistent infection when patients are sent to confirm the resolution of SARS-CoV-2 infection.
ABSTRACT
PURPOSE: To report a case of a Descemet membrane's (DM) detachment after radial keratotomy (RK). METHODS: A patient (male) underwent RK (16 cuts) 20 years before referring to the Eye Center of Humanitas (Milan) for a progressive visual loss. The slit-lamp examination showed severe corneal stromal edema and a large DM detachment in the lower half of the cornea. Anterior segment optical coherence tomography (AS-OCT) and endothelial cells count confirmed DM detachment and endothelial cells damage. Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) was planned and topical hypertonic therapy was prescribed before the surgery. RESULTS: Eight months later, the patient mentioned a spontaneous increase in visual acuity; the slit-lamp examination and the AS-OCT displayed a recovery of corneal transparency with a resolution of DM detachment. CONCLUSIONS: This is the first report of spontaneous DM detachment with severe corneal edema after RK. We suggest that hypertonic therapy may reduce DM detachment and restore corneal transparency.
ABSTRACT
PURPOSE: To report the unknown coexistence of bilateral optic disc pit and keratoconus. METHODS: A 23-year-old man with bilateral keratoconus underwent complete ophthalmology screening, with an unexpected detection of undiagnosed optic disc pit in both eyes. Computerized corneal topography (CT), Orbscan, corneal pachometry, endothelial microscopy, and optical coherence tomography (OCT) examination were performed. RESULTS: The corneal CT showed a keratoconus pattern in both eyes, evolved in the right eye with a minimum corneal pachometry of 336 micronm in the right eye and 405 micronm in the left eye. Mean endothelial cell density was 1937 cells/mm2 in the right eye and 1912 cells/mm2 in the left eye. The OCT scans showed the presence of the disc pit in both eyes with a normal macular thickness and profile in the right eye, and in the left eye an augmented retinal thickness in the nasal macular zone due to retinal oedema and schisis, with an initial detachment of the neuroepithelium in the parapapillary area starting from the optic pit. CONCLUSIONS: This is the first clinical report of bilateral optic disc pit and keratoconus. Further investigations will be necessary to assess if there is a possible pathogenetic correlation between these two ocular pathologies or if this is an unusual coexistence of separate entities.
