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Sharma A, Singh A, Bansal Y, Mohan A, Gnanaraj R, Khulbe P, Pangtey K, Tripathi K, Khan MA, Sharma A, Jain M. Dyschromatopsia and contrast sensitivity changes in COVID-19 patients. Indian J Ophthalmol 2024; 72:664-671. [PMID: 38153970 PMCID: PMC11168548 DOI: 10.4103/ijo.ijo_1437_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/05/2023] [Accepted: 10/19/2023] [Indexed: 12/30/2023] Open
Abstract
PURPOSE To evaluate the alterations in the psycho-physical tests, contrast sensitivity (CS) and hue discrimination (total estimation score, TES) in COVID-19 patients. METHODS A prospective case-control study was undertaken in 2021-22 to look at CS and TES among COVID-19 patients and RT-PCR negative normal subjects by a mobile app "smart optometry" and X-Rite's free online version of Farnsworth-Munsell 100 hue test. Strict visual acuity (minimum of 6/9 equivalent on Snellen) and other clinical parameters were used as exclusion criteria to filter potentially confounding pre-receptoral co-morbid conditions. The effect of mismatch in recruiting age and sex matched controls during the pandemic were analyzed by multivariate linear regression. RESULT One-way ANOVA ruled out any influence of gender on CS and TES; however, there was significant difference in the TES on Mann Whitney U test (TES- 2.95 +/- 3.8 for cases; 0.30 +/- 1.1 for controls; p <0.001) and it persisted after accounting for age. Six controls with breakthrough infections had a significant deterioration in TES (Mean scores -3.0; 95% CI = -5.89 to -0.11; p = 0.04) on paired t test. Qualitative analysis showed that S-cone mediated deficiencies outnumber those affecting M-L cone mediated deficiencies. Among 53 subjects exhibiting three sensory features, anosmia, loss of taste and dyschromatopsia, nine (16.98%) had all features concurrently. CONCLUSION The study demonstrates that COVID-19 infection leads to altered TES representing dyschromatopsia -an ocular counterpart of anosmia, with little difference on CS.
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Affiliation(s)
- Aditi Sharma
- Department of Ophthalmology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Aditya Singh
- Department of Ophthalmology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Yashik Bansal
- Department of Microbiology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Aditi Mohan
- Department of Ophthalmology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Ramya Gnanaraj
- Postdoctoral Research Fellow at Sue Anschutz Rodgers Eye Center, Colorado, United States
| | - Pranita Khulbe
- Department of Ophthalmology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Kavita Pangtey
- Department of Ophthalmology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Kaushiki Tripathi
- Department of Ophthalmology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Mohammad Ali Khan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, L8P 1H6, Canada
| | - Akshita Sharma
- Department of Ophthalmology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Manish Jain
- Department of Ophthalmology, VCSG Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
- Department of Ophthalmology, Al Dhannah Hospital, Ruwais, Western Region, Abu Dhabi, UAE
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Kayabaşı M, Köksaldı S, Saatci AO, Bajin MS. Presentation of Ocular Syphilis with Bilateral Optic Neuropathy. Neuroophthalmology 2023; 47:274-280. [PMID: 38130808 PMCID: PMC10732629 DOI: 10.1080/01658107.2023.2222800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/31/2023] [Indexed: 12/23/2023] Open
Abstract
A 60-year-old otherwise healthy male presented with a 1 year history of bilateral progressive visual loss. His best-corrected visual acuity was counting fingers at 2 m with his right eye and counting fingers at 0.5 m with his left eye. Visual field testing revealed bilateral near-total loss of visual fields. Slit-lamp examination was unremarkable, apart from bilateral grade two nuclear sclerotic cataracts. Both optic discs were pale-looking with some retinal pigment epithelial alterations at the left papillomacular region. Enhanced depth imaging optical coherence tomography depicted punctate hyperreflective dots at the inner choroidal level corresponding to the retinal pigment epithelial changes in the left eye. Fundus autofluorescence imaging revealed patchy hyper-autofluorescent and hypo-autofluorescent areas, and there was mild staining in the early and late phases of the fluorescein angiogram at the papillomacular region in the left eye. A diagnosis of bilateral optic neuropathy was made. A full systemic work-up was carried out, and serological tests pointed out the presence of syphilis with normal cranial magnetic resonance imaging. He was treated accordingly. Our case clearly demonstrates the importance of a high clinical suspicion for syphilis in cases of optic neuropathy.
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Affiliation(s)
- Mustafa Kayabaşı
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Seher Köksaldı
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Ali Osman Saatci
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
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Orman G, Sungur G. Ophthalmologic Assesment of Patients with Syphilitic Optic Neuropathy. Ocul Immunol Inflamm 2022; 31:760-767. [PMID: 35442838 DOI: 10.1080/09273948.2022.2046791] [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: 10/18/2022]
Abstract
PURPOSE To assess the different clinical findings and symptoms of patients with optic neuritis (ON) and uveitis, who were diagnosed with syphilis. METHODS The medical records of patients, who had ocular involvement of syphilis, were retrospectively reviewed. Thirteen patients with syphilitic optic neuropathy (SON) were enrolled and underwent complete ophthalmological examinations and auxiliary laboratory testing. RESULTS Nine patients (69.2%) had comorbidities in addition to syphilis. One patient (with two eyes) presented with retrobulbar neuritis, and 12 patients (with 17 eyes) presented with anterior optic neuritis. Three patients (23.1%) had no uveitis, and 10 patients (76.9%) had uveitis in cases with SON. Four eyes (16.6%) had subretinal fluid, and three eyes (12.5%) had cystoid macular edema. CONCLUSIONS Visual function can be preserved with early diagnosis and proper treatment. Accordingly, newly diagnosed patients with ON and uveitis should undergo syphilitic investigation in routine practice.
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Affiliation(s)
- Gözde Orman
- Department of Ophthalmolgy, Health Science University Ankara Researching and Training Hospital, Ankara, Turkey
| | - Gülten Sungur
- Department of Ophthalmolgy, Health Science University Ankara Researching and Training Hospital, Ankara, Turkey
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Yosar J. Neurosyphilis presenting as visually asymptomatic bilateral optic perineuritis. BMJ Case Rep 2019; 12:12/12/e232520. [PMID: 31871011 DOI: 10.1136/bcr-2019-232520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
A 39-year-old Caucasian man presented with headaches and retro-orbital pain but normal vision. Bilateral optic nerve swelling was found on funduscopy though optic nerve function and computed perimetry were normal and there was no relative afferent pupillary defect. CT venogram and MRI were unremarkable. Cerebrospinal fluid (CSF) opening pressure was normal on lumbar puncture and Treponema pallidum antibodies and T. pallidum particle agglutination test were positive on CSF analysis. He tested negative for HIV. Symptoms rapidly resolved with 2 weeks of intravenous benzylpenicillin. At 1 month follow-up, the right optic nerve swelling had reduced while the left optic nerve swelling had increased; his vision remained unaffected and he was symptom free and continued to have no objective evidence of optic nerve dysfunction.
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Affiliation(s)
- Jason Yosar
- Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia
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