[SARS-CoV-2, COVID-19 and the eye: An update on published data]

Multiple Evanescent White Dot Syndrome Associated with Coronavirus Infection: A Case Report

Coronavirus disease 2019 (COVID-19) causes ocular manifestations in approximately 11% of patients. Most patients typically develop ocular symptoms within 30 days of the onset of the first COVID-19 symptoms. The most common ocular manifestation is conjunctivitis, which affects nearly 89% of patients with eye problems. Other much less common anterior segment abnormalities caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are scleritis, episcleritis, and acute anterior uveitis. Posterior segment abnormalities caused by SARS-CoV-2 are mainly vascular, such as hemorrhages, cotton wool spots, dilated veins, and vasculitis. Herein, we report a rare manifestation of COVID-19 and multiple evanescent white dot syndrome (MEWDS) of the retina. In April 2021, a 40-year-old female patient was admitted to the Eye Clinic of Clinical Center of Montenegro (Podgorica, Montenegro). The patient's main complaint was sudden vision impairment, which occurred 14 days after a positive polymerase chain reaction (PCR) test result for SARS-CoV-2 infection. A complete eye examination was performed, followed by fundoscopy, optical coherence tomography (OCT), and fluorescein angiography (FA) tests. The results showed retinal changes associated with MEWDS. The patient underwent additional examinations to rule out common causes of multifocal retinitis, all of which were unremarkable. Therefore, it was concluded that retinitis was a complication of COVID-19. Given its non-invasive nature, fundus examination should be used as a standard screening method for retinal changes in patients with COVID-19.

Ocular Manifestations of Post-Acute COVID-19 Syndrome, Upper Egypt Early Report

Purpose

To evaluate the ocular manifestations of post-acute COVID-19 syndrome.

Methods

A retrospective, comparative study included 100 patients who had recovered from COVID-19 and 100 controls who were recruited by stratified randomization from hospital registration system and analyzed regarding history, full ophthalmological examination, general examination including internal medicine and neurological evaluation. Laboratory tests were done.

Results

Mean±SD of age were 55.5 ± 6.2 in COVID group vs 56.5 ± 5.8 in control group; P value = 0.7. In COVID group, 57 patients (57%) were males vs 51 patients (51%) in control group (P value = 0.39), the other compared parameters including history and risk factors showed non-significant difference except for ESR and D-dimer which were elevated in COVID group. In COVID group, 5 patients (5%) were having retinal vascular occlusion, 2 patients (2%) were having anterior ischemic optic neuropathy AION, 3 patients (3%) were having uveitis and 2 patients (2%) were having central serous chorioretinopathy CSCR. While in control group, 2 patients (2%) were having retinal vascular occlusion, and none had AION, uveitis or CSCR (P value = 0.006).

Conclusion

Post-acute COVID-19 syndrome could affect the eyes in the form of coagulation problems, neurological morbidities, and other manifestations. This necessitates meticulous follow-up of recovered patients from COVID-19.

Evaluation of Anti-SARS-CoV-2 IgA in the Conjunctival Secretions of COVID-19 Patients

Purpose

To assess the presence of anti-SARS-CoV-2 IgA in the conjunctival secretions of confirmed COVID-19 patients by nasopharyngeal swabs and correlate its presence with the severity of the disease, patient's age, sex and ocular symptoms.

Methods

This study included 44 positive COVID-19 patients confirmed with nasopharyngeal swabs during the period 17-28 February 2021 at Sohag Tropical Medicine Hospital. Tears and conjunctival secretions were examined for the presence of anti-SARS-CoV-2 IgA.

Results

While non-reactive results are strongly correlated to low titre and vice versa, severity showed significant correlation with neither IgA reactivity nor titre. Meanwhile, IgA reactivity did not show significant correlation with either age or sex. The reactivity and IgA titre are correlated with ocular symptoms.

Conclusion

The anti-SARS-CoV-2 IgA could be found in ocular secretions in SARS-CoV-2 patients. There is no correlation with age or sex or severity of the disease; however, they are correlated with ocular symptoms.