1
|
Abrishami M, Hassanpour K, Bayat K, Hosseini SM, Amini N, Abrishami M, Sayyah Ensan P, Heidarzadeh HR. Optic nerve head alterations after COVID-19: an optical coherence tomography angiography-based longitudinal study. J Int Med Res 2024; 52:3000605241263236. [PMID: 39082309 PMCID: PMC11295231 DOI: 10.1177/03000605241263236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/31/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE To evaluate longitudinal changes in peripapillary vessel density (VD) following coronavirus disease 2019 (COVID-19) using optical coherence tomography angiography. METHODS As part of a prospective longitudinal observational study, we studied healthy individuals with a history of mild COVID-19 confirmed via real-time polymerase chain reaction. After recovery, we used the Optovue RTVue XR Avanti machine to perform optic nerve head (ONH) imaging. We also assessed the VD of all vessels and of small vessels in the disc and the radial peripapillary capillary (RPC) network at 1 and 3 months post-recovery. RESULTS We included 17 patients (34 eyes; mean age: 36.9 ± 10.2 years, range: 24-62 years) who had recovered from COVID-19. No changes were observed in the ONH parameters. However, there was a noticeable trend of increased small vessel VD values in the RPC. These increases were significant for the peripapillary whole, superior hemifield, inferior-temporal, temporal-superior, and superior-temporal small vessels. Moreover, the evaluation of all vessel VD values in the RPC revealed a significant decrease in the inside disc and a significant increase in a grid-based inferior region. CONCLUSION COVID-19 may affect VD of the RPC in the ONH, and should be considered in ONH evaluations.
Collapse
Affiliation(s)
- Mojtaba Abrishami
- Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Canada
| | - Kiana Hassanpour
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kia Bayat
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Maryam Hosseini
- Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasibeh Amini
- Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Abrishami
- Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parham Sayyah Ensan
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Hamid Reza Heidarzadeh
- Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
2
|
Végh A, Csorba A, Koller Á, Mohammadpour B, Killik P, István L, Magyar M, Fenesi T, Nagy ZZ. Presence of SARS-CoV-2 on the conjunctival mucosa in patients hospitalized due to COVID-19: Pathophysiological considerations and therapeutic implications. Physiol Int 2022; 109:475-485. [DOI: 10.1556/2060.2022.00113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/29/2022] [Accepted: 08/15/2022] [Indexed: 11/22/2022]
Abstract
AbstractIntroductionCoronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in a worldwide pandemic, due to its great capacity to invade the human body. Previous studies have shown that the primary route of invasion of this virus is the human respiratory tract via the co-expression of ACE2 receptor and TMPRSS2, a serine protease on the cellular surface. Interestingly, this condition is present not only on the respiratory epithelium but on the conjunctival mucosa, as well. Thus, we hypothesized that SARS-CoV-2 is present on the conjunctival mucosa.AimTo prove that SARS-CoV-2 can be detected in the conjunctiva.MethodsPreviously nasopharyngeal swab-sample based real-time polymerase chain reaction (PCR) positive COVID-19 infected patients were selected at the COVID Care Centers of Semmelweis University, Budapest, Hungary. The study was approved by the ethical committee of Semmelweis University. During their recovery, both nasopharyngeal and conjunctival swab-samples were taken and PCR method was used to detect the presence of SARS-CoV-2 RNA. Appropriate statistical analysis was performed.ResultsThe study population consisted of 97 patients, 49 females (50.5%) and 48 males (49.5%), with a mean age of 67.2 ± 11.9 years. During recovery, with nasopharyngeal swabs, the PCR test was positive in 55 cases (56.70%), whereas with conjunctival swabs it was positive in 8 cases (8.25%). Both tests were positive in 5 cases (5.15%). In some patients, ocular symptoms were observed as well. The rest of the patients (29 cases) had negative nasopharyngeal PCR tests during recovery.ConclusionsAlthough only in few cases, the data of the present study provides a proof of concept that SARS-CoV-2 can be present on the conjunctival mucosa even in nasopharyngeal negative patients, a finding, which can have clinical importance. Also, on the basis of these findings one can hypothesize that - in addition to the respiratory tract – the conjunctiva can be an entrance route for SARS-CoV-2 to the human body. Thus, in high-risk conditions, in addition to covering the mouth and nose with mask, the protection of the eyes is also strongly recommended.
Collapse
Affiliation(s)
- András Végh
- Semmelweis University, Department of Ophthalmology, Budapest, Hungary
| | - Anita Csorba
- Semmelweis University, Department of Ophthalmology, Budapest, Hungary
| | - Ákos Koller
- Semmelweis University, Translational Medicine Institute, Budapest, Hungary
- Hungarian University of Sports Sciences, Research Center for Sports Physiology, Budapest, Hungary
| | | | - Petra Killik
- Semmelweis University, Department of Ophthalmology, Budapest, Hungary
| | - Lilla István
- Semmelweis University, Department of Ophthalmology, Budapest, Hungary
| | - Márton Magyar
- Semmelweis University, Department of Ophthalmology, Budapest, Hungary
| | - Teréz Fenesi
- Semmelweis University, Department of Ophthalmology, Budapest, Hungary
| | - Zoltán Zsolt Nagy
- Semmelweis University, Department of Ophthalmology, Budapest, Hungary
| |
Collapse
|
3
|
Letsoalo HL, Mathebula SD. A case of severe endogenous endophthalmitis with orbital cellulitis post COVID-19. AFRICAN VISION AND EYE HEALTH 2022; 81:748. [PMCID: PMC9557940 DOI: 10.4102/aveh.v81i1.748] [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: 11/05/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a novel pandemic viral illness which may lead to severe respiratory diseases. However, its ophthalmic manifestations are still not well understood. There could be serious complications involving various organs in patients with the disease and in those who are recovering, or have recovered, from COVID-19. Endogenous endophthalmitis, was a rare occurrence in the past but has increased in the post-COVID-19 pandemic. Endogenous endophthalmitis results from hematogenous spread from a remote primary source. A 55-year-old man with confirmed COVID-19 presented to a local hospital with unilateral gradual loss of vision and swelling of the left eye that occurred 10 days after discharge from the hospital. Based on detailed ophthalmic examination, this patient with a co-morbidity, namely diabetes mellitus was placed in the intensive care unit where he was given corticosteroids and ventilation for two weeks. Most patients requiring mechanical ventilation may experience disorders of the eye, and it may be difficult to treat these occurrences while the patient remains in ICU. COVID-19 can lead to ocular complications especially in the late stages of infection. Follow-up of post COVID-19 patients is crucial to monitor possible ocular complaints including endophthalmitis as early diagnosis and treatment is essential to salvage vision.
Collapse
Affiliation(s)
- Herold L. Letsoalo
- Department of Ophthalmology, Botshilu Private Hospital, Ga-Rankuwa, South Africa
| | - Solani D. Mathebula
- Department of Optometry, Faculty of Health Sciences, University of Limpopo, Sovenga, South Africa
| |
Collapse
|
4
|
Abrishami M, Hassanpour K, Hosseini S, Emamverdian Z, Ansari-Astaneh MR, Zamani G, Gharib B, Abrishami M. Macular vessel density reduction in patients recovered from COVID-19: a longitudinal optical coherence tomography angiography study. Graefes Arch Clin Exp Ophthalmol 2021; 260:771-779. [PMID: 34636996 PMCID: PMC8505785 DOI: 10.1007/s00417-021-05429-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 12/19/2022] Open
Abstract
Background/aims To quantify the longitudinal changes of the macular microvasculature and the foveal avascular zone (FAZ) parameters in patients recovered from coronavirus disease-2019 (COVID-19) using optical coherence tomography angiography (OCTA) analysis. Methods This observational, longitudinal study was performed on patients recovered from COVID-19. The OCTA images were recorded at baseline and after 1 and 3 months at the follow-up examination. Vessel density (VD) of the retinal superficial (SCP) and deep capillary plexus (DCP), as well as the area of the FAZ of patients who had recovered from COVID-19, were measured. Results In total, 36 eyes of 18 patients (62.2% female) with a mean age of 34.5 ± 7.5 years old were included. Regarding SCP, while the VDs of the whole image, fovea, and parafovea were comparable at different time points, the mean VDs in inferior hemifield, as well as superior and inferior regions of perifovea, underwent significant reductions at month 3, compared to the baseline. In DCP, the mean of VD in the whole image was 54.3 ± 2.7 at the first visit which significantly decreased to 52.1 ± 3.8(P = 0.003) and 51.4 ± 2.7(P = 0.001) after 1 and 3 months, respectively. The VDs in all regions of parafovea and perifovea revealed a significant reduction after 1 and 3 months, compared to the first visit. The mean FAZ area was 0.27 ± 0.08 mm2, 0.26 ± 0.08 mm2, and 0.27 ± 0.08 mm2 at the baseline, month 1, and month 3, respectively (P > 0.05). Conclusion Based on the results, the patients who had recovered from COVID-19 had a progressive decrease of VD at the follow-up visit 3 months after COVID-19 infection.
![]()
Collapse
Affiliation(s)
- Mojtaba Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Eye Research Center, Khatam-al-Anbia Eye Hospital, Qarani Blvd, Mashhad, 9195965919, Iran.
| | - Kiana Hassanpour
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Emamverdian
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ghodsieh Zamani
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bahareh Gharib
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
5
|
Jevnikar K, Jaki Mekjavic P, Vidovic Valentincic N, Petrovski G, Globocnik Petrovic M. An Update on COVID-19 Related Ophthalmic Manifestations. Ocul Immunol Inflamm 2021; 29:684-689. [PMID: 33826465 DOI: 10.1080/09273948.2021.1896008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose: To summarize ophthalmic manifestations of coronavirus disease (COVID-19) reported in the literature thus far.Methods: The PubMed database was systematically searched through October 24, 2020, to identify relevant articles using the following search terms: ("COVID-19" OR "SARS-CoV-2") AND ("eye" OR "ophthalmology" OR "retina" OR "retinal findings" OR "cornea" OR "conjunctiva"). Only articles published in English were included in this review.Results: The reported prevalence of ophthalmic manifestations is generally low, but correlates positively with the severity of the disease. Most commonly reported ocular manifestations are conjunctivitis, conjunctival hyperemia and chemosis. Retinal findings include microhemorrhages and flame-shaped hemorrhages, cotton wool spots, dilated veins, and tortuous vessels.Conclusion: Considering the COVID-19 cases have reached pandemic dimensions and are surging, yet again, it is of utmost importance to determine its ophthalmic manifestations and prevent their vision threatening complications. Further studies are warranted to establish whether the retinal findings appear due to the COVID-19 or are an incidental finding in patients with a preexisting diabetic or hypertensive retinopathy.
Collapse
Affiliation(s)
- Kristina Jevnikar
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Polona Jaki Mekjavic
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Natasa Vidovic Valentincic
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Goran Petrovski
- Center for Eye Research, Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mojca Globocnik Petrovic
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
6
|
Domínguez-Varela IA, Rodríguez-Gutiérrez LA, Morales-Mancillas NR, Barrera-Sánchez M, Macías-Rodríguez Y, Valdez-García JE. COVID-19 and the eye: a review. Infect Dis (Lond) 2021; 53:399-403. [PMID: 33566704 DOI: 10.1080/23744235.2021.1882697] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND To provide a review for general practitioners and medical specialists about the most common eye complaints and ocular manifestations in a COVID-19 patient. METHODS Reviewed 50 articles referenced in 4 databases from 20 December 2019 to 16 September 2020. RESULTS Of the 50 articles reviewed, 26 met the criteria for analysis and were included in the study. Among them were 5 reviews, 6 case series, 7 case reports, 4 cross-sectional studies, 2 systematic reviews, 1 cohort study and 1 correspondence. We found that the prevalence of ocular manifestations in patients during the course of COVID-19 varied between 0.8% and 31.6%, depending on the study design. Symptoms of acute conjunctivitis were the most frequent clinical findings. Acute phase reactants were also correlated to ocular manifestations and the severity of the systemic disease in many reports. CONCLUSIONS Ocular manifestations are not uncommon in COVID-19 patients and have been associated with higher levels of acute phase reactants as well as a higher degree of severity of the systemic disease. We recommend that all physicians consider COVID-19 as a differential diagnosis in the presence of acute conjunctivitis with or without systemic symptoms.
Collapse
Affiliation(s)
- Irving Armando Domínguez-Varela
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Luis Alberto Rodríguez-Gutiérrez
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Nallely Rubí Morales-Mancillas
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Maximiliano Barrera-Sánchez
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Yolanda Macías-Rodríguez
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| | - Jorge Eugenio Valdez-García
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Monterrey, México
| |
Collapse
|