Subject(s)
Eye Infections, Viral , Multimodal Imaging , Retinal Diseases , Rubella , Humans , Eye Infections, Viral/diagnostic imaging , Eye Infections, Viral/virology , Fluorescein Angiography , Retinal Diseases/diagnostic imaging , Retinal Diseases/etiology , Retinal Diseases/virology , Rubella/complications , Rubella/diagnosisABSTRACT
Purpose: The purpose of this study was to investigate the limbal changes in the palisades of Vogt (POV) in patients with herpes simplex keratitis (HSK) and herpes zoster ophthalmicus (HZO) with the application of in vivo confocal microscopy (IVCM). Methods: We enrolled 35 eyes of 35 consecutive patients with HSK and 4 patients with HZO in this observational study. Thirty-five participants were also recruited from a healthy population as the control group. All subjects were examined by IVCM in addition to routine slit-lamp biomicroscopy. The IVCM images of the corneal basal epithelial cells, corneal nerve, and the corneoscleral limbus were acquired and then were analyzed semiquantitatively. Results: The rate of absent and atypical POV was significantly higher in the affected eyes of patients with HSK than in the contralateral eyes and eyes of controls (88.57% vs. 65.71% vs. 17.14%, P < 0.01). In the HZO group, the rate of absent and atypical POV was 100% in the affected eyes and 50% in the contralateral eyes. When compared to the contralateral unaffected eyes and control eyes, the average density of the central basal epithelial cells and the sub-basal nerve plexus density and the total number of nerves in the central area of the affected eyes were significantly lower in the HSK group (1541 ± 704.4 vs. 2510 ± 746.8 vs. 3650 ± 746.1 cells/mm2, P < 0.0001). Spearman's rank correlation showed that the presence of absent and atypical POV had a significant negative correlation with central corneal basal epithelial cells (rs = -0.44979, P < 0.0001), the density of total nerves (rs = -0.49742, P < 0.0001), and the total nerve numbers (rs = -0.48437, P < 0.0001). A significant positive correlation was established between the presence of absent and atypical POV and HSK severity in affected eyes in the superior, inferior, nasal, and temporal quadrants (rs = 0.68940, rs = 0.78715, rs = 0.65591, and rs = 0.75481, respectively, P < 0.0001) and the contralateral eyes (rs = 0.51636, rs = 0.36207, rs = 0.36990, rs = 0.51241, correspondingly, P < 0.0001). Conclusions: Both eyes of patients with unilateral HSK and HZO demonstrated a profound and significant loss of limbal stem cells, which may explain the fact that HSK and HZO are risk factors for limbal stem cell deficiency (LSCD) in both eyes. The loss of LSCs was strongly correlated with the sub-basal nerve plexus and central basal epithelial cell alterations as shown by IVCM.
Subject(s)
Eye Infections, Viral/pathology , Herpes Zoster Ophthalmicus/pathology , Keratitis, Herpetic/pathology , Limbus Corneae/pathology , Stem Cells/pathology , Adult , Cell Count , Cross-Sectional Studies , Eye Infections, Viral/diagnostic imaging , Female , Herpes Zoster Ophthalmicus/diagnostic imaging , Humans , Keratitis, Herpetic/diagnostic imaging , Limbus Corneae/diagnostic imaging , Male , Microscopy, Confocal , Middle Aged , Prospective StudiesSubject(s)
COVID-19/physiopathology , Eye Infections, Viral/physiopathology , Retinal Diseases/physiopathology , Retinal Vessels/physiopathology , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/virology , COVID-19 Nucleic Acid Testing , Eye Infections, Viral/diagnostic imaging , Eye Infections, Viral/virology , Humans , Retinal Diseases/diagnostic imaging , Retinal Diseases/virology , Retinal Vessels/diagnostic imaging , Tomography, Optical CoherenceABSTRACT
OBJECTIVE: To quantify the density of the macular microvasculature and the area of the foveal avascular zone (FAZ) in patients recovered from coronavirus disease 2019 (COVID-19) using optical coherence tomography angiography (OCTA) analysis. METHODS: In a comparative cross-sectional, observational study, patients recovered from COVID-19 were included in this study. All included subjects exhibited a reverse transcription-polymerase chain reaction-confirmed diagnosis of COVID-19. Spectral domain macular OCTA was performed at least 2 weeks after recovery from systemic COVID-19. Vessel density (VD) of the superficial (SCP) and deep retinal capillary plexus (DCP) and the area of the FAZ were measured in COVID-19 recovered patients versus age-matched normal controls. RESULTS: Thirty-one recovered COVID-19 patients and 23 healthy normal controls were studied. Mean quality scan index was 7.64 ± 0.66 in the COVID cases and 8.34 ± 0.71 in the normal controls (pâ¯=â¯0.001). Mean SCP VD and DCP VD of the COVID cohort were significantly lower than the SCP VD and DCP VD of the control group in the foveal and parafoveal regions. FAZ area was greater in the COVID cohort, but this difference was not statistically significant. In addition, in the COVID cohort, VD of the SCP was lower in patients with a history of COVID-19 hospitalization versus those without such a history, but this did not reach statistical significance. CONCLUSIONS: Patients recovered from COVID-19 displayed alterations in the retinal microvasculature, including a significantly lower VD in the SCP and DCP. Patients with coronavirus infection may be at risk of retinal vascular complications.
Subject(s)
COVID-19/physiopathology , Eye Infections, Viral/physiopathology , Retinal Diseases/physiopathology , Retinal Vessels/physiopathology , SARS-CoV-2 , Adult , COVID-19/diagnosis , COVID-19/virology , COVID-19 Nucleic Acid Testing , Case-Control Studies , Cross-Sectional Studies , Eye Infections, Viral/diagnostic imaging , Eye Infections, Viral/virology , Female , Fluorescein Angiography , Humans , Male , Microvessels , Middle Aged , Recovery of Function , Retinal Diseases/diagnostic imaging , Retinal Diseases/virology , Retinal Vessels/diagnostic imaging , Tomography, Optical Coherence , Visual Acuity/physiologySubject(s)
COVID-19/complications , Eye Infections, Viral/etiology , Optic Nerve Diseases/etiology , Retinal Diseases/etiology , SARS-CoV-2/immunology , Scotoma/etiology , Tomography, Optical Coherence , Acute Disease , Adult , COVID-19/diagnosis , COVID-19/virology , COVID-19 Serological Testing , Eye Infections, Viral/diagnostic imaging , Eye Infections, Viral/virology , Female , Humans , Male , Optic Nerve Diseases/diagnostic imaging , Optic Nerve Diseases/virology , Pregnancy , Retinal Diseases/diagnostic imaging , Retinal Diseases/virology , Scotoma/diagnostic imaging , Scotoma/virologyABSTRACT
PURPOSE: To describe a case of Acute Zika infection with ocular involvementMethods: Review of clinical recordsResults: Patient presented with sudden blurred vision in both eyes during an acute episode of zika virus infection. Ophthalmological examination revealed clinical picture of multifocal choroiditis in both eyes. Lesions improved and visual acuities returned to normal level without any treatment.Conclusion: Ocular changes in acute Zika virus infection is a rare condition. Patiens may present spontaneous recovery.
Subject(s)
Eye Infections, Viral/virology , Multifocal Choroiditis/virology , Zika Virus Infection/virology , Acute Disease , Eye Infections, Viral/diagnostic imaging , Female , Humans , Middle Aged , Multifocal Choroiditis/diagnostic imaging , Tomography, Optical Coherence , Visual Acuity/physiology , Zika Virus Infection/diagnostic imagingABSTRACT
This report presents two cases of epidemic keratoconjunctivitis (EKC)-associated dacryocystitis. Both patients presented with preseptal edema. Orbital computed tomography (CT) scans were performed out of concern for orbital cellulitis and revealed soft tissue edema involving the preseptal aspect of the eyelids and also the lacrimal sac. Both patients were initially diagnosed with bacterial preseptal cellulitis with dacryocystitis and admitted for treatment with intravenous antibiotics. After no improvement on antibiotics, both patients were noted to have exam findings consistent with viral conjunctivitis, and one patient had a positive conjunctival swab for adenovirus. Both patients were subsequently treated with topical steroids, and symptoms improved. EKC has previously been identified as a cause of acquired nasolacrimal duct obstruction and canalicular stenosis, and acute inflammation of the lacrimal apparatus may explain this link. Dacryocystitis may also be contributory to the copious tearing seen in patients with epidemic keratoconjunctivitis.
Subject(s)
Adenovirus Infections, Human/complications , Dacryocystitis/etiology , Eye Infections, Viral/complications , Keratoconjunctivitis/complications , Adenovirus Infections, Human/diagnostic imaging , Adult , Dacryocystitis/diagnostic imaging , Eye Infections, Viral/diagnostic imaging , Female , Humans , Keratoconjunctivitis/diagnostic imaging , Lacrimal Duct Obstruction/etiology , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Herpes simplex virus (HSV) can affect the central nervous system causing meningitis, encephalitis and, rarely, acute retinal necrosis. We present a case of a 46-year-old man, previously healthy complaining of a 5-day persistent headache and sudden loss of vision of his left eye that progressed to the right. We started ceftriaxone, methylprednisolone and acyclovir for suspected encephalitis with vasculitis. HSV-1 was identified in vitreous and aqueous humour. Therapy with acyclovir was maintained and two intravitreous boluses of foscarnet were administered, without improvement. Usually being a benign infection, HSV can, in rare cases like this, have catastrophic effects in the optic tract.
Subject(s)
Acyclovir/administration & dosage , Antiviral Agents/administration & dosage , Eye Infections, Viral/drug therapy , Retinal Necrosis Syndrome, Acute/therapy , Administration, Intravenous , Eye Infections, Viral/complications , Eye Infections, Viral/diagnostic imaging , Herpesvirus 1, Human/isolation & purification , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Retinal Detachment/etiology , Retinal Detachment/surgery , Retinal Necrosis Syndrome, Acute/complications , Retinal Necrosis Syndrome, Acute/diagnostic imaging , Retinal Necrosis Syndrome, Acute/virology , Vitreous Body/virologySubject(s)
Adenovirus Infections, Human/diagnostic imaging , Cicatrix/diagnostic imaging , Corneal Diseases/diagnostic imaging , Eye Infections, Viral/diagnostic imaging , Tomography, Optical Coherence , Adenovirus Infections, Human/virology , Anterior Eye Segment , Corneal Diseases/virology , Diagnosis, Differential , Eye Infections, Viral/virology , HumansSubject(s)
Choroid Hemorrhage/virology , Eye Infections, Viral/diagnostic imaging , Magnetic Resonance Imaging , Optic Nerve/diagnostic imaging , Retinal Hemorrhage/diagnostic imaging , Severe Dengue/diagnostic imaging , Acute Disease , Choroid Hemorrhage/diagnostic imaging , Choroid Hemorrhage/surgery , Eye Infections, Viral/surgery , Eye Infections, Viral/virology , Humans , Male , Optic Nerve/pathology , Retinal Hemorrhage/surgery , Retinal Hemorrhage/virology , Severe Dengue/surgery , Severe Dengue/virology , Vitrectomy , Vitreous Hemorrhage/diagnostic imaging , Vitreous Hemorrhage/surgery , Vitreous Hemorrhage/virology , Young AdultABSTRACT
A case of acute annular outer retinopathy (AAOR) is presented in a patient that was later proved to be positive for the human immunodeficiency virus (HIV). The aetiology of AAOR remains unknown, although a viral infection or an autoimmune mechanism has been suggested. The case presented here is noteworthy because it is the first case described in a patient with HIV positive serology. Even so, the precise role played by HIV infection or secondary immunosuppression in the development of the AAOR is not known.
Subject(s)
Eye Infections, Viral , HIV Infections/complications , Retinal Diseases/virology , Acute Disease , Adult , Eye Infections, Viral/diagnostic imaging , Fluorescein Angiography , HIV Infections/diagnosis , Humans , Male , Retinal Diseases/diagnostic imaging , Scotoma/diagnostic imaging , Tomography, Optical CoherenceABSTRACT
Importance: Differentiation between Ebola retinal lesions and other retinal pathologies in West Africa is important, and the pathogenesis of Ebola retinal disease remains poorly understood. Objective: To describe the appearance of Ebola virus disease (EVD) retinal lesions using multimodal imaging to enable inferences on potential pathogenesis. Design, Setting, and Participants: This prospective case series study was carried out at 34 Military Hospital in Freetown, Sierra Leone. Ophthalmological images were analyzed from 14 consecutively identified survivors of EVD of Sierra Leonean origin who had identified Ebola retinal lesions. Main Outcomes and Measures: Multimodal imaging findings including ultra-widefield scanning laser ophthalmoscopy, fundus autofluorescence, swept-source optical coherence tomography (OCT), Humphrey visual field analysis, and spatial analysis. Results: The 14 study participants had a mean (SD) age of 37.1 (8.8) years; 6 (43%) were women. A total of 141 Ebola retinal lesions were observed in 22 of 27 eyes (81%) of these 14 survivors on ultra-widefield imaging. Of these, 41 lesions (29.1%) were accessible to OCT imaging. Retinal lesions were predominantly nonpigmented with a pale-gray appearance. Peripapillary lesions exhibited variable curvatures in keeping with the retinal nerve fiber layer projections. All lesions respected the horizontal raphe and spared the fovea. The OCT imaging demonstrated a V-shaped hyperreflectivity of the outer nuclear layer overlying discontinuities of the ellipsoid zone and interdigitation zone in the smaller lesions. Larger lesions caused a collapse of the retinal layers and loss of retinal thickness. Lesion shapes were variable, but sharp angulations were characteristic. Perilesional areas of dark without pressure (thinned ellipsoid zone hyporeflectivity) accompanied 125 of the 141 lesions (88.7%) to varying extents. Conclusions and Relevance: We demonstrate OCT evidence of localized pathological changes at the level of the photoreceptors in small lesions among survivors of EVD with retinal lesions. The relevance of associated areas of dark without pressure remains undetermined.
Subject(s)
Eye Infections, Viral/diagnostic imaging , Hemorrhagic Fever, Ebola/diagnostic imaging , Ophthalmoscopy/methods , Retinal Diseases/diagnostic imaging , Tomography, Optical Coherence/methods , Visual Fields/physiology , Adult , Eye Infections, Viral/physiopathology , Female , Fluorescein Angiography/methods , Hemorrhagic Fever, Ebola/physiopathology , Humans , Male , Multimodal Imaging , Prospective Studies , Retinal Diseases/physiopathology , Sierra Leone , Survivors , Visual Acuity/physiology , Visual Field TestsABSTRACT
PURPOSE: To evaluate the morphological characteristics of posterior corneal regions including keratic precipitates in eyes with cytomegalovirus (CMV) corneal endotheliitis using anterior segment spectral domain optical coherence tomography (SD-OCT). METHODS: Thirteen eyes of 13 patients with polymerase chain reaction-proven CMV corneal endotheliitis were included in this study. Slit-lamp images and anterior segment SD-OCT images of the posterior cornea were obtained to analyze the clinical characteristics of corneal structures and keratic precipitates. Morphological changes in the posterior cornea throughout the course of an antiviral treatment were also investigated. RESULTS: Anterior SD-OCT images showed protruding structures at the posterior cornea. These protruding structures exhibited dendritic, dome-shaped, quadrangular, or saw-tooth appearance, and reflectivity of these structures was high. Reflectivity of posterior corneal images including the endothelium and deep stromal corneal regions were also high (76.9%). Because corneal inflammation and corneal edema improved, the protruding structures and high-intensity regions of posterior corneal images were resolved after a course of antiviral treatment. CONCLUSIONS: The anterior segment SD-OCT examination represents a useful noninvasive alternative to diagnose and monitor CMV corneal endotheliitis.
Subject(s)
Cytomegalovirus Infections/diagnostic imaging , Endothelium, Corneal/diagnostic imaging , Eye Infections, Viral/diagnostic imaging , Keratitis/diagnostic imaging , Tomography, Optical Coherence , Aged , Anterior Eye Segment/diagnostic imaging , Antiviral Agents/therapeutic use , Aqueous Humor/virology , Corneal Edema/diagnosis , Corneal Edema/diagnostic imaging , Corneal Edema/drug therapy , Corneal Edema/virology , Cytomegalovirus/genetics , Cytomegalovirus/isolation & purification , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/virology , DNA, Viral/genetics , Eye Infections, Viral/diagnosis , Eye Infections, Viral/drug therapy , Eye Infections, Viral/virology , Female , Ganciclovir/therapeutic use , Humans , Keratitis/diagnosis , Keratitis/drug therapy , Keratitis/virology , Male , Middle Aged , Polymerase Chain ReactionABSTRACT
ABSTRACT This case report describes the retinal optical coherence tomography (OCT) findings in a microcephalic infant with macular atrophy presumably caused by intrauterine Zika virus infection. OCT demonstrated atrophy of the outer retinal layers and choriocapillaris, including the outer nuclear layer and ellipsoid zone, associated with retinal pigment epithelium hyper-reflectivity and increased OCT penetration into deeper layers of the choroid and sclera. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with the Zika virus. It is becoming increasingly difficult to ignore the upsurge in congenital microcephaly observed in Brazil. Recently, ocular findings in infants with microcephaly associated with intrauterine Zika virus infection have been described. This is the first report of OCT imaging of macular atrophy in a child with presumed Zika virus infection-associated microcephaly.
Este relato de caso descreve os achados da tomografia de coerência óptica (TCO) da retina de uma criança com microcefalia e atrofia macular presumivelmente causada por infecção intra-uterina pelo vírus Zika. Tomografia de coerência óptica demonstrou camadas externas da retina e atrofia coriocapilar, incluindo a camada nuclear externa e zona de elipsóide, associada a hiperreflectividade do epitélio pigmentar da retina e aumento de penetração da tomografia de coerência óptica em camadas mais profundas da coróide e esclera. Uma grande preocupação associada com esta infecção é o aumento aparente da incidência de microcefalia em fetos nascidos de mães infectadas com o vírus Zika. É cada vez mais difícil ignorar o surto de microcefalia congênita observada no Brasil. Recentemente, foram descritos achados oculares em crianças com microcefalia associados à infecção pelo vírus Zika intra-uterino. Este é o primeiro relato de tomografia de coerência óptica com atrofia macular em uma criança com microcefalia associada a infecção presumida por vírus Zika.
Subject(s)
Humans , Male , Female , Infant, Newborn , Retinal Diseases/diagnostic imaging , Eye Infections, Viral/diagnostic imaging , Zika Virus Infection/complications , Macula Lutea/pathology , Microcephaly/virology , Retinal Diseases/virology , Atrophy , Tomography, Optical Coherence , Macula Lutea/diagnostic imagingSubject(s)
Eye Infections, Viral/diagnostic imaging , Hand, Foot and Mouth Disease/diagnostic imaging , Multimodal Imaging/methods , Retinal Diseases/diagnostic imaging , Acute Disease , Animals , Coxsackievirus Infections/diagnostic imaging , Female , Fluorescein Angiography , Hand, Foot and Mouth Disease/complications , Humans , Retinal Diseases/complications , Tomography, Optical Coherence , Young AdultABSTRACT
CASE REPORT: This article reports a case of an Epstein-Barr virus (EBV) associated acute retinal necrosis. A 72-year-old male patient presented in the emergency department complaining of progressive loss of vision. During patient management an acute retinal necrosis was suspected and the subsequent diagnostics from a vitreal body biopsy showed positive results only for the EBV genome. OBJECTIVE: The EBV is a rare cause of ocular inflammation. With this report we would like to draw the attention of colleagues to this unusual finding. CONCLUSION: Although EBV screening is not part of the standard diagnostic procedure, its implementation in relevant clinical situations could possibly assist the differentiation between causal relationship and morbidity.
Subject(s)
Epstein-Barr Virus Infections/diagnosis , Epstein-Barr Virus Infections/virology , Eye Infections, Viral/diagnostic imaging , Eye Infections, Viral/virology , Retinal Necrosis Syndrome, Acute/diagnosis , Retinal Necrosis Syndrome, Acute/virology , Aged , Diagnosis, Differential , Herpesvirus 4, Human/isolation & purification , Humans , Male , Vision Disorders/diagnosis , Vision Disorders/virologySubject(s)
Eye Infections, Viral/diagnostic imaging , Herpes Zoster Ophthalmicus/diagnostic imaging , Herpesvirus 3, Human/isolation & purification , Macula Lutea/diagnostic imaging , Macula Lutea/pathology , Retinal Necrosis Syndrome, Acute/diagnostic imaging , Tomography, Optical Coherence , Acyclovir/therapeutic use , Antiviral Agents/therapeutic use , Aqueous Humor/virology , Drug Therapy, Combination , Eye Infections, Viral/drug therapy , Eye Infections, Viral/virology , Female , Fluorescein Angiography , Glucocorticoids/therapeutic use , Herpes Zoster Ophthalmicus/drug therapy , Herpes Zoster Ophthalmicus/virology , Humans , Middle Aged , Necrosis , Polymerase Chain Reaction , Retinal Necrosis Syndrome, Acute/drug therapy , Retinal Necrosis Syndrome, Acute/virologyABSTRACT
This case report describes the retinal optical coherence tomography (OCT) findings in a microcephalic infant with macular atrophy presumably caused by intrauterine Zika virus infection. OCT demonstrated atrophy of the outer retinal layers and choriocapillaris, including the outer nuclear layer and ellipsoid zone, associated with retinal pigment epithelium hyper-reflectivity and increased OCT penetration into deeper layers of the choroid and sclera. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with the Zika virus. It is becoming increasingly difficult to ignore the upsurge in congenital microcephaly observed in Brazil. Recently, ocular findings in infants with microcephaly associated with intrauterine Zika virus infection have been described. This is the first report of OCT imaging of macular atrophy in a child with presumed Zika virus infection-associated microcephaly.