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Marzoog BA. Manifestations of coronavirus infection disease-19 in anterior eye segment: An up-to-date review. Oman J Ophthalmol 2024; 17:4-10. [PMID: 38524336 PMCID: PMC10957037 DOI: 10.4103/ojo.ojo_237_22] [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: 08/15/2022] [Accepted: 10/25/2023] [Indexed: 03/26/2024] Open
Abstract
Coronavirus infection disease-19 (COVID-19) is a worldwide catastrophic emergency that first appeared in late 2019, in Wuhan, China. COVID-19 is a multitropism disease that first affects lung tissue. However, extrapulmonary manifestations have been suspected from the first COVID-19 cases. The ocular signs and symptoms were from the early changes that occur during the course of the disease. Changes in the anterior eye segment have a relatively higher incidence than the posterior eye segment. Of which, conjunctivitis, COVID-19 pharyngioceratoconjuctivitis, iridocyclitis, corneal punctate epitheliopathy, and pathomorphological changes in the physio-anatomy of the anterior eye segment. The potential pathogenesis includes direct penetration of the virus into the eye (conjunctiva, lumbus, and cornea) or due to a systemic pathway through viremia, as well as due to autoimmune antibodies against the ocular structure (immune privilege). The presence of ocular manifestations of the external anterior fibrous layer suggests a mild course of the disease.
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Affiliation(s)
- Basheer Abdullah Marzoog
- World-Class Research Center, Digital Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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2
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Claessens D, Huber-van der Velden K, Krüger R. [Pupillary Dysfunction, Anisocoria and Iris Depigmentation Following COVID-19]. Klin Monbl Augenheilkd 2023. [PMID: 37586402 DOI: 10.1055/a-2118-0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
| | | | - Ronald Krüger
- Gemeinschaftspraxis Augenheilkunde Lindenthal, Köln, Deutschland
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Gulmez Sevim D, Sener H, Evereklioglu C. Bilateral Acute Iris Transillumination and Elevated Intraocular Pressure After COVID-19 Infection. J Glaucoma 2023; 32:e56-e59. [PMID: 36946913 DOI: 10.1097/ijg.0000000000002214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/26/2023] [Indexed: 03/23/2023]
Abstract
Bilateral acute iris transillumination (BAIT) is characterized by abundant pigment discharge into the anterior chamber. Atonic pupil and severe intraocular pressure (IOP) elevations may be observed. Generally, there is a viral upper respiratory tract infection or systemic fluoroquinolone usage before BAIT. Two cases with a recent history of coronavirus disease 2019 (COVID-19) presented with a complaint of decreased vision. Elevated IOP and iris transillumination defects were observed in both patients. Both patients were diagnosed with BAIT. Although elevated IOP was controlled with medical treatment in 1 patient, glaucoma surgery was performed in the other patient because it could not be controlled with medical treatment. As both patients received no systemic treatment for COVID-19, the pressure rise seems to be directly related to the viral infection alone through the inflammatory process. Atypical ocular presentations of COVID-19 should be kept in mind as it can have serious consequences.
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Lončarić K, Tadić R, Radmilović M, Vatavuk Z. Bilateral Acute Iris Transillumination (BAIT): A Rare Syndrome Possibly Associated with COVID-19 and Moxifloxacin Use. A Report of 2 Cases. Semin Ophthalmol 2023; 38:312-315. [PMID: 36653737 DOI: 10.1080/08820538.2023.2168491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Bilateral acute iris transillumination (BAIT) is a rare clinical entity, presumed to be associated with preceding upper respiratory tract infection and/or use of certain antibiotics, marked by bilateral acute loss of iris pigment epithelium with pigment dispersion in the anterior chamber and trabecular meshwork, which can cause elevated intraocular pressure and glaucoma, and with iris transillumination and sphincter paralysis which lead to photophobia and blurry vision. We report the first two cases of BAIT in our center which both had a history of preceding COVID-19 (coronavirus disease 2019) and moxifloxacin use. With more awareness, ophthalmologists might diagnose more cases, and thus gain more information regarding the link between COVID-19 and BAIT, which might be underdiagnosed since it is rare or easily misdiagnosed as some more common diseases with similar features.
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Affiliation(s)
- Kristina Lončarić
- Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Rašeljka Tadić
- Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Marin Radmilović
- Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Zoran Vatavuk
- Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
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5
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Bilateral acute iris transillumination syndrome after SARS-CoV-2 infection: A case report. J Fr Ophtalmol 2023; 46:e54-e56. [PMID: 36635209 PMCID: PMC9816075 DOI: 10.1016/j.jfo.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/19/2022] [Accepted: 08/26/2022] [Indexed: 01/09/2023]
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Altan C, Basarir B, Bayraktar S, Tugal-Tutkun I. Bilateral Acute Depigmentation of Iris (BADI) and Bilateral Acute Iris Transillumination (BAIT)Following Acute COVID-19 Infection. Ocul Immunol Inflamm 2022:1-6. [PMID: 36083696 DOI: 10.1080/09273948.2022.2103832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE To report the presenting features and outcomes in patients who developed bilateral acute iris transillumination (BAIT) or bilateral acute depigmentation of iris (BADI) following acute COVID-19 infection. METHODS Thirty two eyes of 16 patients were reviewed retrospectively. The severity of COVID-19 infection, use of antibiotics, time of onset of ocular symptoms; ocular signs, the course and surgical procedures were recorded. RESULTS 24 eyes of 12 BAIT and eight eyes of four consecutive BADI patients were included. The mean time between infection and onset of ocular symptoms was 2.5±1.1 weeks. Nine patients were treated with oral moxifloxacin for COVID-19 prior to presentation. Trabeculectomy was performed in 7 eyes (21.8%) of 5 BAIT patients; in the postoperative follow-up, IOP was controlled without medication in 6 eyes, with medication in 1 eye. CONCLUSION BADI and BAIT can also develop after COVID-19 infection. A significant proportion of BAIT patients may require glaucoma surgery.
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Affiliation(s)
- Cigdem Altan
- Beyoglu Eye Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Berna Basarir
- Beyoglu Eye Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Serife Bayraktar
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Ophthalmology, Bayrampasa Eye Hospital, Istanbul, Turkey
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Niedzwiecka E, Cantó San Miguel MP, Gonzalez Herrera M, Sánchez Rodriguez-Acosta I. Bilateral Acute Depigmentation of the Iris (BADI) following Covid-19 Infection. Ocul Immunol Inflamm 2022:1-2. [PMID: 36040969 DOI: 10.1080/09273948.2022.2113801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE To present a case of bilateral acute iris depigmentation after covid 19 infection. CASE REPORT A 55-year-old female presented with binocular pain and blurred vision a month after being diagnosed with severe acute respiratory syndrome - coronavirus-2 (SARS-CoV-2). She presented pigment dispersion in the anterior chamber and pigment depositions on the corneal endothelium. The patient was treated with dexamethasone and during follow-up visits, the pigment dispersion decreased and the symptoms ceased. CONCLUSIONS Covid-19 infection may be associated with rare ocular disorders such as BADI.
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Affiliation(s)
- E Niedzwiecka
- Ophthalmology Department, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Spain
| | - M P Cantó San Miguel
- Ophthalmology Department, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Spain
| | - M Gonzalez Herrera
- Ophthalmology Department, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Spain
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Gaur S, Sindhu N, Singh DV, Bhattacharya M, Sharma A, Shinde D. COVID-19-related bilateral acute de-pigmentation of iris with ocular hypertension. Indian J Ophthalmol 2022; 70:3136-3139. [PMID: 35918989 DOI: 10.4103/ijo.ijo_75_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 43-year-old male patient presented with acute blurring of vision in both eyes associated with photophobia, redness, and mild pain following coronavirus disease 2019 (Covid-19) infection. Clinical examination revealed extensive pigment dusting in the corneal endothelium and the trabecular meshwork with de-pigmentation bands in the iris periphery. The patient was managed empirically with topical anti-glaucoma medications for high intra-ocular pressure. The patient was prescribed systemic antibiotics including cephalosporins and amoxicillin for respiratory symptoms. A rare condition called bilateral acute de-pigmentation of iris (BADI) was suspected after ruling out common entities, for example, viral kerato-uveitis, pigment dispersion syndrome, and Fuchs iridocyclitis. Covid-19 infection and systemic antibiotics including cephalosporins have shown to cause BADI in the literature. The patient responded well with good outcome.
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Affiliation(s)
- Sandhya Gaur
- Department of Ophthalmology, Cornea Anterior Segment Services, Eye-Q Super Speciality Eye Hospitals, Gurugram, Haryana, India
| | - Narottama Sindhu
- Department of Ophthalmology, Cornea Anterior Segment Services, Eye-Q Super Speciality Eye Hospitals, Gurugram, Haryana, India
| | - Deependra Vikram Singh
- Department of Ophthalmology, Cornea Anterior Segment Services, Eye-Q Super Speciality Eye Hospitals, Gurugram, Haryana, India
| | - Mainak Bhattacharya
- Department of Ophthalmology, Cornea Anterior Segment Services, Eye-Q Super Speciality Eye Hospitals, Gurugram, Haryana, India
| | - Ajay Sharma
- Department of Ophthalmology, Cornea Anterior Segment Services, Eye-Q Super Speciality Eye Hospitals, Gurugram, Haryana, India
| | - Dattatraya Shinde
- Department of Ophthalmology, Cornea Anterior Segment Services, Eye-Q Super Speciality Eye Hospitals, Gurugram, Haryana, India
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Arora A. Commentary: COVID-19-related bilateral acute depigmentation of iris with ocular hypertension. Indian J Ophthalmol 2022; 70:3140. [PMID: 35918990 DOI: 10.4103/ijo.ijo_1297_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Atul Arora
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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10
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Yüksel M, Özdemir HB, Özdek Ş, Gürelik G. Bilateral acute Iris transillumination after COVID-19 pneumonia. Eur J Ophthalmol 2022:11206721221113428. [PMID: 35850544 PMCID: PMC9297069 DOI: 10.1177/11206721221113428] [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] [Indexed: 11/16/2022]
Abstract
PURPOSE To report the diagnosis, treatment and follow-up of a case of bilateral acute iris transillumination (BAIT) developed after COVID-19 pneumonia. METHOD Case report. CASE A 66-year-old male patient with COVID-19 pneumonia received systemic treatments of favipiravir, prednisolone, moxifloxacin and piperacillin-tazobactam during hospitalization. The patient applied to our clinic with the complaint of blurred vision 20 days after the diagnosis of COVID-19. The best corrected visual acuity (BCVA) was 0.3 in the right eye and 0.5 in the left eye. In the anterior segment examination; ciliary injection, intense pigment dispersion in the anterior chamber, pigment deposits on the lens and iris, 2-3 + cells in the anterior chamber, posterior synechia, and 360 degrees diffuse iris transillumination were observed in both eyes. The pupillary response to light was weak. Bilateral fundus examination were normal. In the anterior chamber sample; HSV, VZV, CMV and Toxoplasma PCR were negative. Bilateral acute iris transillumination (BAIT) diagnosed in the patient and topical 0.1% dexamethasone and topical 1% cyclopentolate were started. In the follow-up, visual acuity increased 1.0 in both eyes, there were no cells in the anterior chamber, and the pigment dispersion was still continuing despite a decrease. CONCLUSION BAIT, which can usually be seen after upper respiratory tract infections, can also be seen after covid 19 pneumonia and be kept in mind as a possible eye involvement in patients with COVID-19 infection.
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Affiliation(s)
- Murat Yüksel
- Department of Ophthalmology, 37511Gazi University School of Medicine, Ankara, Turkey
| | - Hüseyin Baran Özdemir
- Department of Ophthalmology, 37511Gazi University School of Medicine, Ankara, Turkey
| | - Şengül Özdek
- Department of Ophthalmology, 37511Gazi University School of Medicine, Ankara, Turkey
| | - Gökhan Gürelik
- Department of Ophthalmology, 37511Gazi University School of Medicine, Ankara, Turkey
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Patnaik G, Arunkumar WV, Lagvankar M. Bilateral Acute Depigmentation of Iris (BADI) Post COVID Infection following Systemic Moxifloxacin Therapy. Ocul Immunol Inflamm 2022:1-3. [PMID: 35486641 DOI: 10.1080/09273948.2022.2069126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To report a case of BADI post Covid infection following systemic moxifloxacin therapy. METHODS Observational case study. CASE REPORT A 28-year-old female presented to us with complaints of redness and pain in the right eye since 5 days. History revealed use of systemic moxifloxacin for covid infection. She was managed with topical corticosteroids and cycloplegics following a diagnosis of BADI. CONCLUSION Bilateral acute depigmentation of iris (BADI) is a rare disease entity associated with the release of iris pigments. Various underlying aetiologies have been associated with the same. Although BADI is a benign, self-limiting disorder, it needs to be differentiated with other potential severe clinical entities. SARS-CoV2 has been associated with various ocular manifestations. However, to the best of our knowledge, BADI has never been associated with COVID infection yet. We report a case of BADI in a young healthy Asian middle - aged female 3 months after an acute COVID infection.
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Affiliation(s)
- Gazal Patnaik
- Department of Uvea & Medical Retina, Sankara Nethralaya, Kolkata, India
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Cunningham ET, Zierhut M. SARS-CoV-2, COVID-19, and the Eye. Ocul Immunol Inflamm 2021; 29:629-630. [PMID: 34596492 DOI: 10.1080/09273948.2021.1970423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Emmett T Cunningham
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA.,The Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA.,The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California, USA
| | - Manfred Zierhut
- Centre for Ophthalmology, University Tuebingen, Tuebingen, Germany
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