1
|
Scalabrin S, Becco A, Vitale A, Nuzzi R. Ocular effects caused by viral infections and corresponding vaccines: An overview of varicella zoster virus, measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2. Front Med (Lausanne) 2022; 9:999251. [PMID: 36388944 PMCID: PMC9643669 DOI: 10.3389/fmed.2022.999251] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/30/2022] [Indexed: 09/19/2023] Open
Abstract
Many viral infections can affect vision and the visual system. Vaccination to prevent diseases is commonplace today, acting by stimulating an immune response without developing the pathology. It involves the production of persisting antibodies against the pathogen and the activation of T cells. Certain diseases have already been eradicated by rigorous vaccination campaigns, while others are hoped to be eliminated soon. Vaccines currently available on the market are largely safe, even if they can rarely cause some adverse effects, such as ocular complications. Analyzing existing literature, we aimed to compare the pathological effects on the eye due to the most common viral infections [in particular varicella zoster virus (VZV), measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2] with the possible ocular adverse effects of their relative vaccines, in order to establish a risk-benefit relationship from an ophthalmological point of view.
Collapse
Affiliation(s)
| | | | | | - Raffaele Nuzzi
- Department of Surgical Sciences, Eye Clinic, University of Turin, Turin, Italy
| |
Collapse
|
2
|
Venkatesh A, Patel R, Goyal S, Rajaratnam T, Sharma A, Hossain P. Ocular manifestations of emerging viral diseases. Eye (Lond) 2021; 35:1117-1139. [PMID: 33514902 PMCID: PMC7844788 DOI: 10.1038/s41433-020-01376-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/02/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
Emerging infectious diseases (EIDs) are an increasing threat to public health on a global scale. In recent times, the most prominent outbreaks have constituted RNA viruses, spreading via droplets (COVID-19 and Influenza A H1N1), directly between humans (Ebola and Marburg), via arthropod vectors (Dengue, Zika, West Nile, Chikungunya, Crimean Congo) and zoonotically (Lassa fever, Nipah, Rift Valley fever, Hantaviruses). However, specific approved antiviral therapies and vaccine availability are scarce, and public health measures remain critical. Patients can present with a spectrum of ocular manifestations. Emerging infectious diseases should therefore be considered in the differential diagnosis of ocular inflammatory conditions in patients inhabiting or returning from endemic territories, and more general vigilance is advisable in the context of a global pandemic. Eye specialists are in a position to facilitate swift diagnosis, improve clinical outcomes, and contribute to wider public health efforts during outbreaks. This article reviews those emerging viral diseases associated with reports of ocular manifestations and summarizes details pertinent to practicing eye specialists.
Collapse
Affiliation(s)
- Ashwin Venkatesh
- grid.5335.00000000121885934School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ravi Patel
- grid.439257.e0000 0000 8726 5837Moorfields Eye Hospital, London, UK
| | - Simran Goyal
- grid.5335.00000000121885934School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Timothy Rajaratnam
- grid.5335.00000000121885934School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Anant Sharma
- grid.439257.e0000 0000 8726 5837Moorfields Eye Hospital, London, UK
| | - Parwez Hossain
- grid.430506.4Eye Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK ,grid.5491.90000 0004 1936 9297Clinical Experimental Sciences, Faculty of Medicine, Univeristy of Southampton, Southampton, UK
| |
Collapse
|
3
|
Bilateral optic neuritis with spine demyelination associated with influenza A H1N1 infection. Am J Ophthalmol Case Rep 2020; 20:101001. [PMID: 33364518 PMCID: PMC7750147 DOI: 10.1016/j.ajoc.2020.101001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 10/12/2020] [Accepted: 12/07/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To report a rare case of optic neuritis with spine demyelination following H1N1 virus infection. Observation A 66-year-old female presented with decreased vision in both eyes (left > right) following a recent episode of fever and flu. She was diagnosed as H1N1 infection confirmed by viral antigen analysis of throat swab. On examination, she had a profound vision drop in the left eye with optic disc edema. MRI brain and orbit revealed bilateral optic nerve and frontal dural thickening with a ring-enhancing lesion in the right frontal lobe. MRI spine showed long cord signals at T1-T7 suggestive of demyelination. The patient had a complete recovery of vision and visual fields after intravenous and oral steroids. Conclusion/Importance Influenza A virus can manifest with a wide range of symptoms including flu-like illness to neurological complications. This case highlights optic neuritis as a presenting feature of H1N1 infection.
Collapse
|
4
|
Brydak-Godowska J, Turczyńska M, Przybyś M, Brydak LB, Kęcik D. Ocular Complications in Influenza Virus Infection. Ocul Immunol Inflamm 2018; 27:545-550. [PMID: 29420099 DOI: 10.1080/09273948.2017.1423335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Purpose: To describe a case series of ocular complications associated with upper respiratory tract infections. Methods: Four patients aged 21-61 years (three females, one male) had confirmed ocular complications connected with a general upper respiratory tract infection with myalgia and fever. Ophthalmological examination, including a visual acuity test, a slit-lamp exam, intraocular pressure measurements, fluorescein and indocyanine green angiography, optical coherence tomography (OCT), and diagnostic tests for influenza were performed in the patients (RT-PCR, HAI). Results: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) was diagnosed in three patients and serous macular detachment (SME) in one. Influenza virus infection was confirmed by molecular biological methods (RT-PCR) or the hemagglutination inhibition test (HAI) in two patients. All patients were treated with systemic prednisone. Conclusion: A coincidence between APMPPE and SME epitheliopathy and influenza virus infection was observed in different months of a given epidemic season.
Collapse
Affiliation(s)
| | - Monika Turczyńska
- a Department of Ophthalmology , Medical University of Warsaw , Warsaw , Poland
| | - Mariusz Przybyś
- a Department of Ophthalmology , Medical University of Warsaw , Warsaw , Poland
| | - Lidia B Brydak
- b Director of the National Influenza Centre, Director of the Department of Influenza Research , National Institute of Public Health - National Institute of Hygiene , Warsaw , Poland
| | - Dariusz Kęcik
- a Department of Ophthalmology , Medical University of Warsaw , Warsaw , Poland
| |
Collapse
|
5
|
Lee JH, Agarwal A, Mahendradas P, Lee CS, Gupta V, Pavesio CE, Agrawal R. Viral posterior uveitis. Surv Ophthalmol 2017; 62:404-445. [PMID: 28012878 PMCID: PMC5654632 DOI: 10.1016/j.survophthal.2016.12.008] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 12/12/2016] [Accepted: 12/13/2016] [Indexed: 12/28/2022]
Abstract
The causes of posterior uveitis can be divided into infectious, autoimmune, or masquerade syndromes. Viral infections, a significant cause of sight-threatening ocular diseases in the posterior segment, include human herpesviruses, measles, rubella, and arboviruses such as dengue, West Nile, and chikungunya virus. Viral posterior uveitis may occur as an isolated ocular disease in congenital or acquired infections or as part of a systemic viral illness. Many viruses remain latent in the infected host with a risk of reactivation that depends on various factors, including virulence and host immunity, age, and comorbidities. Although some viral illnesses are self-limiting and have a good visual prognosis, others, such as cytomegalovirus retinitis or acute retinal necrosis, may result in serious complications and profound vision loss. Since some of these infections may respond well to antiviral therapy, it is important to work up all cases of posterior uveitis to rule out an infectious etiology. We review the clinical features, diagnostic tools, treatment regimens, and long-term outcomes for each of these viral posterior uveitides.
Collapse
Affiliation(s)
- Joanne H Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Aniruddha Agarwal
- Department of Vitreoretina and Uveitis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Cecilia S Lee
- Department of Uveitis, University of Washington, Seattle, Washington, USA
| | - Vishali Gupta
- Department of Vitreoretina and Uveitis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Carlos E Pavesio
- Department of Medical Retina, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom
| | - Rupesh Agrawal
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Medical Retina, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom; Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.
| |
Collapse
|
6
|
Braun R, Holler E, Wolff D, Helbig H, Blecha C, Dietrich-Ntoukas T. [Bilateral ciliary body oedema under treatment with ciclosporine]. Ophthalmologe 2017; 115:55-58. [PMID: 28251308 DOI: 10.1007/s00347-017-0475-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present the case of a 27-year-old female patient who developed bilateral ciliary body edema with secondary glaucoma and myopic shift during systemic treatment with cyclosporine for aplastic anemia. After application of topical atropine and prednisolone acetate and conversion from cyclosporine to tacrolimus, the ophthalmologic symptoms resolved completely. Since an infectious etiology was not evident, we hypothesize that ciliary body edema was caused by impairment of microvascular integrity by cyclosporine.
Collapse
Affiliation(s)
- R Braun
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - E Holler
- Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - D Wolff
- Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - H Helbig
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - C Blecha
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - T Dietrich-Ntoukas
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.,Klinik für Augenheilkunde, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| |
Collapse
|
7
|
Abstract
PURPOSE The purpose of this study is to report a unique case of vaso-occlusive retinal vasculitis in the setting of H1N1 influenza A. METHODS This study includes ophthalmologic examination, fluorescein angiogram, optical coherence tomography, neuroimaging, cerebral spinal fluid analysis, serologies, chart review, and review of the relevant literature. RESULTS A 13-year-old Caucasian female presented with bilateral vision loss accompanied by mental status changes and flu symptoms. Fundus examination revealed bilateral disk edema, peripapillary and macular flame hemorrhages, macular edema, and cherry-red spots. Fluorescein angiogram revealed vaso-occlusive vasculitis resulting in poor perfusion of the maculae. There was also staining of the optic nerves bilaterally. Optical coherence tomography revealed bilateral macular edema with intraretinal and subretinal fluid. CONCLUSION This is a unique case of H1N1 influenza A presenting with vaso-occlusive retinal vasculitis, encephalitis, and flu symptoms. The poor vision is not entirely accounted for by the macular disease. Given the accompanying disk edema, there is likely a similar vaso-occlusive process of the central nervous system that contributed to the bilateral light perception vision.
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW Emergent and resurgent infectious diseases are major causes of systemic morbidity and death that are expanding worldwide mainly because of climate changes and globalization. Among them, specific diseases have been recently associated with ocular involvement. This review presents the ocular manifestations of selected emerging infectious diseases relevant to the ophthalmologist. RECENT FINDINGS An array of ocular manifestations, involving mainly the posterior segment, have been recently described in association with specific arthropod vector-borne diseases including rickettsioses, West Nile virus, Rift Valley fever, Dengue fever, and Chikungunya. Influenza A (H1N1) virus has also been recently associated with ocular involvement. On the contrary, with advances in laboratory testing applied to ocular fluids, new infectious agents, mainly viruses, are increasingly being found to be associated with uveitis. SUMMARY Emerging infectious diseases should be considered in the differential diagnosis of retinitis, chorioretinitis, retinal vasculitis, optic neuropathy, or any other ocular inflammatory condition in a patient living in or traveling back from a specific endemic area. On the contrary, ocular fluid sampling and analysis for specific new pathogens can be recommended in selected patients with uveitis of unexplained cause.
Collapse
|
9
|
Bilateral nanophthalmic uveal effusion syndrome: clinical presentation and surgical management. Retin Cases Brief Rep 2013; 7:386-90. [PMID: 25383821 DOI: 10.1097/icb.0b013e318297f6c1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE To describe the clinical presentation and surgical management of bilateral uveal effusion syndrome in a type 1 diabetic patient with nanophthalmos. METHODS A 38-year-old man presented with decreased visual acuity. Fundus examination revealed exudative retinal detachment and choroidal folding. Ultrasound examination confirmed thickened sclera, choroidal effusion, and nanophthalmos. Partial thickness scleral windows and subscleral sclerectomy were performed. The patient returned 2 years postoperatively with the same presentation in the contralateral eye. RESULTS After subscleral sclerectomy, intraocular pressure remained stable and the patient recovered premorbid vision in both eyes. At 4 years of follow-up, the patient's vision had remained stable without the need for further treatment. CONCLUSION The association of uveal effusion syndrome with diabetes and other autoimmune disorders is unclear, warranting further research. Uveal effusion syndrome can be managed effectively by partial thickness scleral windows and sclerectomy with improvement and maintenance of visual acuity.
Collapse
|
10
|
Khairallah M, Kahloun R, Ben Yahia S, Jelliti B, Messaoud R. New infectious etiologies for posterior uveitis. Ophthalmic Res 2012; 49:66-72. [PMID: 23258387 DOI: 10.1159/000344009] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 09/30/2012] [Indexed: 11/19/2022]
Abstract
Emergent and resurgent arthropod vector-borne diseases are major causes of systemic morbidity and death and expanding worldwide. Among them, viral and bacterial agents including West Nile virus, Dengue fever, Chikungunya, Rift Valley fever, and rickettsioses have been recently associated with an array of ocular manifestations. These include anterior uveitis, retinitis, chorioretinitis, retinal vasculitis and optic nerve involvement. Proper clinical diagnosis of any of these infectious diseases is based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular involvement. The diagnosis is usually confirmed by the detection of a specific antibody in serum. Ocular involvement associated with emergent infections usually has a self-limited course, but it can result in persistent visual impairment. There is currently no proven specific treatment for arboviral diseases, and therapy is mostly supportive. Vaccination for humans against these viruses is still in the research phase. Doxycycline is the treatment of choice for rickettsial diseases. Prevention, including public measures to reduce the number of mosquitoes and personal protection, remains the mainstay for arthropod vector disease control. Influenza A (H1N1) virus was responsible for a pandemic human influenza in 2009, and was recently associated with various posterior segment changes.
Collapse
Affiliation(s)
- Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia.
| | | | | | | | | |
Collapse
|
11
|
Wu C, Dong FT, Zhang H, Chen YX, Dai RP, Tan K. Diagnosis and Treatment of Uveal Effusion Syndrome: a Case Series and Literature Review. ACTA ACUST UNITED AC 2011; 26:231-6. [DOI: 10.1016/s1001-9294(12)60006-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|