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Stawowski AR, Konopińska J, Stawowski SS, Adamczuk J, Groth M, Moniuszko-Malinowska A, Czupryna P. The Review of Ophthalmic Symptoms in COVID-19. Clin Ophthalmol 2024; 18:1417-1432. [PMID: 38803556 PMCID: PMC11129748 DOI: 10.2147/opth.s460224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
The COVID-19 pandemic caused by SARS-CoV-2 had a significant impact on the health of the global human population, affecting almost every human organ, including the organ of vision. Research focus on understanding the pathophysiology, identifying symptoms and complications of the disease. Eye-related pathologies are important foci of research due to the potential for direct impact of the virus. Ophthalmologists around the world are reporting various symptoms of eye infections and ocular pathologies associated with SARS-CoV-2. The review of ophthalmic symptoms was conducted to help physicians of various specialties recognize possible ophthalmic manifestations of this viral disease. A literature review was conducted from January 2020 to July 2023 in the PubMed, MEDLINE, Science Direct, Scopus, Scielo and Google Scholar databases. The review of the literature showed that conjunctivitis is the most common ophthalmic symptom observed during the course of COVID-19 and can occur at any stage of the disease. Changes in the eye may result from the direct effect of the virus, immune response, prothrombotic states, comorbidities, and medications used. Symptoms related to the organ of vision can be divided into: changes affecting the protective apparatus of the eye, the anterior eye segment, the posterior eye segment, neuro-ophthalmic, and orbital changes. Ocular symptoms may suggest COVID-19 infection or appear several weeks after recovery. Following COVID-19 vaccinations, a diverse range of ophthalmic symptoms was observed in various locations and at different times, mirroring the ocular symptoms experienced throughout the course of the COVID-19 illness. It is important for physicians of all specialties to be aware of possible potential connections between eye diseases and SARS-CoV-2, in order to effectively diagnose and treat patients.
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Affiliation(s)
| | - Joanna Konopińska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland
| | | | - Justyna Adamczuk
- Department of Infectious Diseases and Neuroinfectious, Medical University of Bialystok, Bialystok, Poland
| | - Monika Groth
- Department of Allergology and Internal Diseases, University Clinical Hospital in Bialystok, Bialystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfectious, Medical University of Bialystok, Bialystok, Poland
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfectious, Medical University of Bialystok, Bialystok, Poland
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Wang X, Wang P, Lu J, Ju H, Xie H, Peng H. Acute macular neuroretinopathy and COVID-19 or SARS-CoV-2 infection: case report and literature review. Front Med (Lausanne) 2024; 11:1267392. [PMID: 38384420 PMCID: PMC10879554 DOI: 10.3389/fmed.2024.1267392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
Purpose To describe a case of acute macular neuroretinopathy (AMN) associated with COVID-19 infection and a related literature review. Methods A case from the First Affiliated Hospital of Chongqing Medical University was reported that could be linked to COVID-19 or SARS-CoV-2 infection. We performed a comprehensive search on PubMed, retrieving articles containing information on AMN after COVID-19 or SARS-CoV-2 infection. The key words used were 'COVID-19', 'SARS-CoV-2', 'ophthalmic manifestations', 'acute macular neuroretinopathy', and 'paracentral scotomas'. The relevant data were extracted, charted, consolidated, and evaluated. Moreover, manual exploration of the reference lists of pertinent articles was carried out. Results We describe the case of a 30-year-old young woman who developed bilateral AMN one day after being infected with COVID-19 or SARS-CoV-2. She had severe visual impairment (20/2000 OD and 20/32 OS), and her vision recovered after taking oral corticosteroids. After reviewing the literature, we summarized 16 relevant reports and found that symptoms of AMN tend to arise 1 day to 1 month after COVID-19 or SARS-CoV-2 infection. Contraceptive pills and other risk factors should be avoided to reduce the risk of adverse outcomes. Oral prednisone may be an effective treatment for those experiencing important vision loss. Conclusion Symptoms of AMN can arise 1 day to 1 month after COVID-19 or SARS-CoV-2 infection. Ophthalmologists should remain vigilant about this disease, notably because patient characteristics may deviate from the norm.
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Affiliation(s)
- Xing Wang
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Ophthalmology, Department of Ophthalmology, Chongqing Eye Institute, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Wang
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Ophthalmology, Department of Ophthalmology, Chongqing Eye Institute, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Lu
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Huan Ju
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Hao Xie
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Hui Peng
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Ophthalmology, Department of Ophthalmology, Chongqing Eye Institute, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Rastegar Rad N. COVID-19 and children's eyes. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2024; 12:213-216. [PMID: 38601049 PMCID: PMC11002461 DOI: 10.51329/mehdiophthal1488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/29/2024] [Indexed: 04/12/2024]
Affiliation(s)
- Nima Rastegar Rad
- Head of Ophthalmology Division, Shahid Beheshti Clinic, Karaj, Alborz, Iran
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Zaidi AK, Singh RB, A A Rizvi S, Dehgani-Mobaraki P, Palladino N. COVID-19 pathogenesis. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2024; 202:67-112. [PMID: 38237991 DOI: 10.1016/bs.pmbts.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
The pathogenesis of COVID-19 involves a complex interplay between host factors and the SARS-CoV-2 virus, leading to a multitude of clinical manifestations beyond the respiratory system. This chapter provides an overview of the risk factors, genetic predisposition, and multisystem manifestations of COVID-19, shedding light on the underlying mechanisms that contribute to extrapulmonary manifestations. The chapter discusses the direct invasion of SARS-CoV-2 into various organs as well as the indirect mechanisms such as dysregulation of the renin-angiotensin-aldosterone system (RAAS), immune response dysfunctions within the innate and adaptive immune systems, endothelial damage, and immunothrombosis. Furthermore, the multisystem manifestations of COVID-19 across different organ systems, including the cardiovascular, renal, gastrointestinal, hepatobiliary, nervous, endocrine and metabolic, ophthalmic, ear-nose-throat, reproductive, hematopoietic, and immune systems are discussed in detail. Each system exhibits unique manifestations that contribute to the complexity of the disease.
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Affiliation(s)
| | - Rohan Bir Singh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States; Department of Population, Policy and Practice, Greater Ormond Street Institute of Child Health, University College London, United Kingdom; Discipline of Ophthalmology and Visual Sciences, Adelaide Medical School, University of Adelaide, Australia
| | - Syed A A Rizvi
- College of Biomedical Sciences, Larkin University, Miami, Florida, United States.
| | - Puya Dehgani-Mobaraki
- Founder and President, Associazione Naso Sano, Ringgold Institution ID 567754, San Mariano, Italy.
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Chaudhary S, Sitaula RK, Karki P, Joshi SN. Endogenous endophthalmitis in post-COVID-19 patients: a case report. Ann Med Surg (Lond) 2023; 85:4137-4141. [PMID: 37554872 PMCID: PMC10406071 DOI: 10.1097/ms9.0000000000001051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/01/2023] [Indexed: 08/10/2023] Open
Abstract
UNLABELLED Ocular involvement in coronavirus disease 2019 (COVID-19) can be due to direct viral invasion or indirectly due to an immunosuppressed state. Prolonged hospitalization also makes them susceptible to various secondary infections. The purpose of this case report is to report two rare cases of endogenous endophthalmitis (EE) in COVID-19 recovered patients. CASE PRESENTATION Two patients who were hospitalized and received treatment for COVID-19 pneumonia with remdesivir and systemic steroids presented with decreased vision. The first case had a severe anterior chamber reaction with a hypopyon and dense exudates in the vitreous. The second case had cells and flare in the anterior chamber and exudates in the vitreous. They were diagnosed with EE and underwent a diagnostic vitreous tap followed by pars plana vitrectomy and intravitreal antibiotic and steroid. The culture of vitreous fluid was negative for any bacteria and fungus in both cases. However, the first case demonstrated Escherichia coli in urine culture. The follow-up visual acuity was no perception of light and only perception of light in the first and second case, respectively. CLINICAL DISCUSSION Severe COVID-19 patients who are hospitalized, receive systemic steroid and have associated comorbidities like diabetes mellitus are at high risk of EE. CONCLUSION Delay in diagnosis and appropriate treatment in these patients leads to poor visual outcome.
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Affiliation(s)
- Santosh Chaudhary
- Department of Ophthalmology, B.P. Koirala Institute of Health Sciences, Dharan
| | - Ranju K. Sitaula
- B.P. Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Pratap Karki
- B.P. Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Sagun N. Joshi
- B.P. Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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Sanjay S, Bhakti Mistra S, Patro SK, Kawali A, Shetty R, Mahendradas P. Systemic Markers in Ophthalmic Manifestations of Post Corona Virus Disease-19 (COVID-19). Ocul Immunol Inflamm 2023; 31:410-415. [PMID: 35138993 DOI: 10.1080/09273948.2021.2025253] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Corona virus disease (COVID-19) has been associated with ophthalmic manifestations which can occur during or following the infection. PURPOSE To explore the systemic status in ophthalmic patients who had a recent history of COVID-19 or those with positive COVID-19 antibody status. METHODS Retrospective case series. RESULTS 30 patients with history of COVID-19 infection and positive COVID-19 antibodies were included in the study. The median age was 49 years (mean 48.7 ± 13.7 years), 20 were males (66.7%) and 10 (33.3%) were females. Patients with VA>/= 6/60 were included in group 1 and those with VA<6/60 were included in group 2. D-dimer/serum Ferritin levels were raised in group 2 compared to group 1with (p=0.013)/(p=0.018) respectively. CONCLUSION Serum D-dimer and ferritin levels were statistically significant and were higher in patients with sight threatening ocular manifestations. ESR and CRP were raised even after recovery from COVID-19 although they were not statistically significant.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Sai Bhakti Mistra
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Sithun Kumar Patro
- Department of Community Medicine, MKCG Medical College, Brahmapur, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Rohit Shetty
- Department of Neuro-ophthalmology, Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
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Akbari M, Dourandeesh M. Update on overview of ocular manifestations of COVID-19. Front Med (Lausanne) 2022; 9:877023. [PMID: 36177323 PMCID: PMC9513125 DOI: 10.3389/fmed.2022.877023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 08/08/2022] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) has become the most critical health crisis at present, and research is continued about the exact pathophysiology, presentations, and complications of this pandemic. It influences several organs, and many studies have addressed the organs, the involvement of which during the COVID-19 results in patients' death. One of the important organs that can be involved during COVID-19, which is also a transmission route of the disease, is the eye. According to the evidence, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have ocular manifestations and complications. According to the literature, conjunctivitis is the most common presentation, which can develop at any stage of COVID-19 (during and even after the disease), and the major pathophysiology of the eye involvement during the disease is attributed to the direct effect of the virus on the eyes, tissue damage caused by inflammation, underlying diseases, and the adverse effect of the medications prescribed. There are also reports of life-threatening complications, such as rhino-orbital cerebral mucormycosis, which require urgent treatment and are associated with a great mortality rate. Ocular manifestations may also be the presentation of a life-threatening event, such as stroke; therefore, it is necessary to pay great attention to the ocular manifestations during COVID-19. In this review, after about 2 years of the pandemic started, we present a narrative review on ocular manifestations during COVID-19, categorized into three main categories; ophthalmic, orbital, and neuro-ophthalmological manifestations with a detailed description of the presenting symptoms, risk factor, diagnostic, and therapeutic strategies suggested for each.
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Hsieh T, Gundlach BS, Ashrafzadeh S, Sarraf D, Tsui I. Effects of COVID-19 on Intravitreal Injection Clinic After Lockdown. Clin Ophthalmol 2022; 16:3089-3096. [PMID: 36160732 PMCID: PMC9507280 DOI: 10.2147/opth.s358239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To examine the return of patients to intravitreal injection clinic after the COVID-19 lockdown. Patients and Methods The electronic medical records of all patients who received intravitreal injections at a tertiary care Veterans Health Administration (VHA) clinic 14 weeks post-lockdown (5/9/20-8/13/20) in Los Angeles County were reviewed. Reference groups included injection patients during the 7-week COVID-19 lockdown (3/19/20-5/8/20) and a 7-week pre-pandemic period in 2019 (3/19/19-5/8/19). Clinic volume was compared using a one-way ANOVA. Demographic data, medical and psychiatric co-morbidities, injection diagnoses, visual acuities, and clinic volumes were compared between the 3 periods using a generalized estimating equation multivariate analysis. Results The post-lockdown period group averaged 25.1 visits per week, compared with 12.3/week during lockdown and 25.4/week pre-COVID in intravitreal injection clinic. In the post-lockdown period, the VHA injection clinic returned closer to the pre-lockdown volume compared to the VHA comprehensive clinic (98.9% vs 57.4%, p < 0.001). Post-lockdown, COPD patients and organ transplant patients were less likely to receive injections compared to 2019 (OR 0.76 p = 0.008, OR 1.37 p < 0.0001, respectively). Patients with a diagnosis of cancer increased in proportion between the pre-pandemic and the post-lockdown periods (OR 1.31, p = 0.007). No differences were found, according to psychiatric co-morbidities. After lockdown, the proportion of patients receiving injections for diabetic macular edema (DME) increased (OR 1.11, p = 0.01). Conclusion Injection volume returned to pre-pandemic levels immediately after lockdown ended. However, patients with high-risk comorbidities did not return to intravitreal injection clinic post-lockdown. These results can inform medical organizations, which groups may need increased safety measures and targeted outreach to address their ophthalmic needs.
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Affiliation(s)
- Terry Hsieh
- Stein Eye Institute, University of California, Los Angeles, CA, USA
| | - Bradley S Gundlach
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Sahar Ashrafzadeh
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - David Sarraf
- Ophthalmology Department, West Los Angeles Veterans Health Administration, Los Angeles, CA, USA
- Retinal Disorders and Ophthalmic Genetics - Stein Eye Institute, University of California, Los Angeles, CA, USA
| | - Irena Tsui
- Ophthalmology Department, West Los Angeles Veterans Health Administration, Los Angeles, CA, USA
- Retina Division - Stein Eye Institute, University of California, Los Angeles, CA, USA
- Doheny Eye Institute, University of California, Los Angeles, CA, USA
- Correspondence: Irena Tsui, Ophthalmology Department, West Los Angeles Veterans Health Administration, Los Angeles, CA, USA, Tel +1 310 825 7290, Fax +1 310 825 9946, Email
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