COVID-19 Disease and Ophthalmology: An Update

The worldwide outbreak of the severe and acute respiratory coronavirus disease (COVID-19) caused by the coronavirus strain SARS-CoV-2 is currently the focal point of discussion due to the suffering this syndrome is causing to humanity. However, the ophthalmological implications of this syndrome has not yet been well described. Both eyes and tears as portals of entry and sources of contagion have been the subject of debate by many authors. The purpose of this review is to summarize the evidence currently available on COVID-19 and its ocular implications and manifestations, in both animals and humans, with the aim to facilitate prevention and educate the ophthalmological community on this subject. A review of the literature revealed that the results of some studies suggest that ocular symptoms commonly appear in patients with severe COVID-19 pneumonia and that it is possible to isolate the virus from the conjunctival sac of these patients. Conjunctivitis is not a common manifestation of the disease, but contact with infected eyes could be one route of transmission. Consequently, ophthalmologists need to have correct prevention strategies in place. Some guidelines regarding the prevention and management of ophthalmology clinics are reviewed. However, well-designed trials should be conducted to rule out other ocular manifestations that may result from COVID-19 infection and to understand the transmission of the virus through the eyes.

A survey of canine respiratory pathogens in New Zealand dogs

AIMS To determine which of the common canine respiratory pathogens circulate among selected populations of healthy and diseased dogs in New Zealand. METHODS Coagulated blood samples for serology and oropharyngeal swabs for virology were collected from healthy dogs (n=47) and from dogs with acute respiratory disease (n=49). For diseased dogs a convalescent blood sample was also collected 3-4 weeks later. Oropharyngeal swabs were subjected to virus isolation and tested for canine parainfluenza virus (CPIV), canine adenovirus (CAdV) 2, canine herpesvirus (CHV), canine respiratory coronavirus (CRCoV), canine influenza virus (CIV), canine distemper virus (CDV), Bordetella bronchiseptica, Streptococcus equi subsp. zooepidemicus, and Mycoplasma cynos nucleic acids by quantitative PCR (qPCR). Sera were tested for CRCoV antibody using competitive ELISA and results expressed as percent of inhibition (POI). RESULTS The mean age of diseased dogs (2.7, min <0.5, max 8.5 years) was lower than the mean age of healthy dogs (5.3, min <0.5, max 17 years) (p<0.001). In total, 20/94 (21%) dogs were positive for at least one agent by qPCR. Diseased dogs were most commonly positive for M. cynos (8/47, 17%), followed by CPIV (3/47, 6%) and B. bronchiseptica (3/47, 6%), while healthy dogs were most commonly positive for CAdV-2 (6/47, 13%), followed by M. cynos (2/47, 4%). All samples were negative for CIV, CRCoV, CDV and S. equi subsp. zooepidemicus. Viruses were not isolated from any of the samples tested. In total, 47/93 (50%) dogs were seropositive for CRCoV on at least one sampling occasion. Samples from diseased dogs were more frequently seropositive for CRCoV, with higher POI, than samples from healthy dogs. CONCLUSIONS AND CLINICAL RELEVANCE We showed that CAdV-2, CPIV, CHV, CRCoV, B. bronchiseptica and M. cynos circulated among sampled dogs. The convenience sampling methodology, with a poor match between the populations of diseased and healthy dogs in terms of age, breed and use, together with the relatively small sample size precluded inference of any causal relationships between infection with a given pathogen and development of disease. None-the-less, our data suggest that further investigation into epidemiology and disease association of CRCoV and M. cynos is warranted. In addition, circulation of novel respiratory pathogens among dogs in New Zealand should be considered in future studies, as 70/94 (74%) diseased dogs were negative for all the pathogens tested.

Canine herpesvirus-1 ocular diseases of mature dogs

Canine herpesvirus-1 (CHV-1) is an alphaherpesvirus with a host range restricted to canids. Latent CHV-1 infection is endemic in domestic dog populations worldwide. The role of CHV-1 in severe systemic neonatal infections and as an aetiology of infectious infertility and abortion has been appreciated for decades; however, ocular diseases of mature dogs conclusively associated with CHV-1 infection were only recently described. Clinically, CHV-1 infection may produce a diverse range of adnexal and ocular surface lesions in mature dogs, including blepharitis, conjunctivitis, ulcerative keratitis, and nonulcerative keratitis. These conditions can develop during primary or recurrent ocular CHV-1 infection. Recurrent CHV-1 infections associated with reactivation of latent virus may be observed during a variety of situations and in association with numerous different viral reactivation stimuli, including the administration of immunosuppressive pharmaceuticals. The understanding of CHV-1 pathophysiology and ocular infections in mature dogs has expanded rapidly during the past few years, but much remains to be elucidated. As the number of dogs living with chronic immunomodulatory systemic diseases and receiving immunosuppressive therapeutics continues to grow, the clinical importance of CHV-1 ocular infections is also likely to increase.

Effects of cyclophosphamide myelosuppression in adult dogs with latent canine herpesvirus-1 infection

Latent canine herpesvirus-1 (CHV-1) infection is common in domestic dogs, but triggers for viral reactivation and recrudescent CHV-1 disease are poorly understood. Cyclophosphamide is a potent immunosuppressive and myelosuppressive agent used for the therapy of a variety of neoplastic and immune-mediated canine disorders. Cyclophosphamide (200mg/m(2)) was administered to mature dogs latently infected with CHV-1 to determine its potential to induce recurrent CHV-1 disease and viral shedding. Non-infected dogs and dogs recovered from experimental primary ocular CHV-1 infection with experimentally confirmed latent CHV-1 infection were divided into groups and administered cyclophosphamide or placebo. Dogs were monitored for myelosuppression and viral reactivation for 28days using clinical and virological outcome measures. Clinical ophthalmic and in vivo ocular confocal microscopic examinations were performed at intervals. Samples were collected for CHV-1 polymerase chain reaction (PCR), CHV-1 virus neutralizing (VN) antibody, and hemogram assays. Myelosuppression (i.e., decreased total leukocyte, segmented neutrophil, and erythrocyte counts) was detected on study day 7 in dogs administered cyclophosphamide, but not dogs administered placebo. There were no abnormalities suggestive of recurrent CHV-1 ocular disease during clinical ophthalmic or in vivo confocal microscopic examination in any dogs during the study. Ocular CHV-1 shedding was not detected by PCR and CHV-1 VN titers remained stable in all dogs. Following study conclusion, the presence of reactivatable latency was reconfirmed in the infected dogs by administering systemic prednisolone. Myelosuppression elicited by a single dose of cyclophosphamide does not result in detectable recurrent ocular CHV-1 infection in adult dogs with experimentally induced latent CHV-1 infection.

Canine reproductive, respiratory, and ocular diseases due to canine herpesvirus

This review documents how clinical inquiry expands as our knowledge base about canine herpesvirus (CHV) increases. We must understand the various forms of CHV infection that may occur in the dog population. This has prompted the veterinary community to develop more sensitive diagnostic assays. CHV is more common than we considered a decade ago. Up to 70% of some high-risk dog populations have been infected with and are latent carriers of CHV. Recognition of the various forms of CHV-induced disease, availability of diagnostic assays with increased sensitivity, and the formation of reliable biosecurity measures will allow for better control steps.

Acute primary canine herpesvirus-1 dendritic ulcerative keratitis in an adult dog

We present a report of dendritic ulcerative keratitis in a 4-year old locally immunosuppressed dog suspected to result from acute primary canine herpesvirus-1 (CHV-1) infection. The dog was presented for evaluation of mild blepharospasm and conjunctival hyperemia in the right eye (OD) shortly after attending a public boarding facility. For approximately 3 months, the dog had been receiving topical prednisolone acetate 1.0% and tacrolimus 0.02% in both eyes (OU) q12h for treatment of follicular conjunctivitis. Ophthalmic examination revealed three regions of corneal fluorescein retention OD. The lesions had a dendritic pattern, were approximately 2-3 mm in length, and were located at the dorsomedial, lateral, and ventromedial aspects of the cornea. No additional abnormalities were noted on complete ophthalmic and physical examinations. CHV-1 was identified in conjunctival samples OD by polymerase chain reaction, and paired CHV-1 serum virus neutralization antibody titers were positive and consistent with acute infection. Topical prednisolone acetate and tacrolimus were discontinued. The dog was treated with cidofovir 0.5% OU q12h for a period of 4 weeks, with resolution of corneal disease noted within 1 week of treatment. In conjunction with previous studies, this case report supports a central role for alterations in host immune status in the pathogenesis and clinical manifestations of CHV-1 ocular disease in dogs.

Seroprevalence of canine herpesvirus-1 in Turkish dog population

Canine herpesvirus-1 (CHV-1) is the agent of reproductive and respiratory disorders in adult dogs, and the infection generally results in haemorrhagic disease conditions and neonatal death. In this study, virus neutralisation test that used complement (VNT) as well as in-house ELISA were utilised to investigate the CHV-1 seroprevalence in the Turkish dog population. Among the 560 serum samples, 39.3% of the samples tested by ELISA were CHV-1 positive while 29.4% of the samples tested by VNT were CHV-1 positive. Compared to the individual dogs (39.0%), there was a higher CHV-1 seroprevalence (62.1%) found in the colony dogs (62.1%) (p=0.0002). However, there was an insignificant difference between male and female dogs. Although the highest antibody prevalence (56.7%) was found in Golden Retrievers, there were no significant variations detected among the dog breeds used in this study. Neutralizing antibody titres were very low (⩽1:16) in a high portion of the tested animals, confirming the rapid decrease of CHV-1 antibodies after the course of infection. The results of this study show that CHV-1 seroprevalence is moderately high in the Turkish dog population.

Outbreak of ocular disease associated with naturally-acquired canine herpesvirus-1 infection in a closed domestic dog colony

OBJECTIVE

To describe clinical and virological findings of an outbreak of ocular disease attributed to naturally-acquired primary canine herpesvirus-1 (CHV-1) infection in a closed domestic dog colony.

ANIMALS STUDIED

Twenty-seven 10- to 16-week-old laboratory Beagles.

PROCEDURE

Complete ophthalmic examinations were performed and ocular samples collected for CHV-1 polymerase chain reaction and virus isolation.

RESULTS

The prevalence of ocular morbidity was 100% in examined dogs. Lesions were restricted to the ocular surface and included bilateral conjunctivitis (100% of dogs); punctate, dendritic, or geographic ulcerative keratitis (26% of dogs); and non-ulcerative keratitis (19% of dogs). Conjunctival petechiae were detected in 22% of dogs. Punctate and dendritic corneal ulcers were frequently organized into discrete groups or linear arrangements. Non-ulcerative keratitis appeared clinically as a perilimbal ring of superficial corneal vascularization and leukocyte infiltration. CHV-1 was detected in ocular samples by polymerase chain reaction or virus isolation in all dogs sampled.

CONCLUSIONS

In susceptible populations of domestic dogs, CHV-1 may be associated with outbreaks of highly contagious ocular infection in the absence of concurrent overt systemic disease. This naturally-acquired outbreak of CHV-1 infection provides an opportunity to report the spectrum and prevalence of ocular lesions associated with primary ocular CHV-1 infection in dogs. Conjunctivitis was the most frequent ocular lesion detected. Ulcerative and non-ulcerative keratitis were less prevalent and of variable clinical appearance. Dendritic ulcerative keratitis, a classic and relatively specific ocular lesion associated with alphaherpesvirus infection, was detected in < 20% of dogs.