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Sun D, Zhan Z, Wang B, Liu T, Yu M, Lan Y, Li J. Expression of the SARS-CoV-2 Receptor ACE2 and Protease TMPRSS2 in Ocular Hypertension Eyes of Nonhuman Primate and Human. Curr Eye Res 2024; 49:270-279. [PMID: 38212998 DOI: 10.1080/02713683.2023.2291749] [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: 07/02/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE Coronavirus disease 2019 is a disease caused by the novel severe acute respiratory syndrome coronavirus 2. The double-positive of angiotensin-converting enzyme 2 and transmembrane protease serine type 2 have a higher risk of being infected by severe acute respiratory syndrome coronavirus 2. The susceptibility of coronavirus disease 2019 in patients with chronic diseases, especially in different tissues of ocular hypertension eyes like glaucoma, is not yet known. METHODS An ocular hypertension model was established by laser photocoagulation in rhesus monkeys. The expression of angiotensin-converting enzyme 2 and transmembrane protease serine type 2 in three ocular hypertension eyes and the three control eyes were analyzed using immunofluorescence. RESULTS No difference was observed between ocular hypertension and control eyes in the expression of angiotensin-converting enzyme 2 and transmembrane protease serine type 2 in the conjunctival epithelium, corneal epithelium, and ciliary muscle. In ocular hypertension eyes and control eyes, angiotensin-converting enzyme 2 and transmembrane protease serine type 2 expression were both observed in the retina. Angiotensin-converting enzyme 2 staining of retinal ganglion cells was found to be significantly higher in ocular hypertension eyes than in control eyes. However, there was no difference in angiotensin-converting enzyme 2 and transmembrane protease serine type 2 expression in retinal vessels and choroidal vessels between ocular hypertension and control eyes. In our study, the expression and distribution of angiotensin-converting enzyme 2 and TMPREE2 in human retina were similar to that of non-human primates as expected. CONCLUSION Our study confirmed that angiotensin-converting enzyme 2 and transmembrane protease serine type 2 were expressed widely in rhesus monkey eyes. When compared with controls eyes, the expression of angiotensin-converting enzyme 2 was higher in the retinal ganglion cells in ocular hypertension eyes, suggesting that high ocular pressure may affect the patients' ocular susceptibility to severe acute respiratory syndrome coronavirus 2 infection.
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Affiliation(s)
- Difang Sun
- Department of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao, China
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zongyi Zhan
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Ophthalmology, Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Bin Wang
- Department of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ting Liu
- Department of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao, China
| | - Minbin Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuqing Lan
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jun Li
- Department of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao, China
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Premi E, Acampora R, Salmi D, Ilie IA, Pagnoncelli N, Germano F, Gandolfi G, Sanicas M, Seed A, Michael BD, Donati S, Azzolini C, Lanfranchi F. Clinical and Diagnostic Findings of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy in the COVID-19 Era. Ophthalmologica 2023; 246:181-191. [PMID: 37573773 PMCID: PMC10614461 DOI: 10.1159/000533530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Growing evidence suggests an association between the infection from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and eye disorders. The aim of this review was to analyze the clinical presentation and diagnostic features of acute macular neuroretinopathy (AMN) and paracentral acute middle maculopathy (PAMM) associated with COVID-19 infection. The features are then compared with previous reports regarding these retinal disorders, to recognize possible specific characteristics and to assess the role of multimodal ophthalmic imaging. SUMMARY A literature search was performed by consulting PubMed, Scopus, and Embase. The following terms were searched: "(COVID-19 OR SARS-CoV-2 OR coronavirus) AND ([acute macular neuroretinopathy] OR [paracentral acute middle maculopathy])." Inclusion criteria were as follows: (1) publication date from January 31, 2020 to January 31, 2022; (2) English language; (3) original research or case report; (4) free full-text availability.Optical coherence tomography (OCT) findings in AMN patients were hyper-reflectivity (HR) of the outer plexiform layer, of the outer nuclear layer, and ellipsoid or interdigitation zones (EZ and IZ, respectively) disruption. In most cases, the presence of HR and EZ/IZ abnormalities resulted combined. When performed, OCT angiography (OCTA) identified attenuation of signal of the deep capillary plexus (DCP). The most common OCT finding in PAMM was an alteration of the inner nuclear layer, associated with other areas of HR, while no signs of EZ/IZ disruption were detected. When performed, OCTA showed the attenuation of signal of both the DCP and the superficial capillary plexus. KEY MESSAGES In this review, we reported a case series of AMN and PAMM in patients with a previous or concomitant infection from SARS-CoV-2. The microvascular changes in these cases are highlighted by the OCTA scans. Even if we are far from the determination of a direct link between COVID-19 and these retinal disorders, we could hypothesize that the vascular alterations associated with SARS-CoV-2 infection could be a possible risk factor for both AMN and PAMM.
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Affiliation(s)
- Elias Premi
- Ophthalmology Unit, ASST Sette Laghi, Circolo Hospital and Macchi Foundation, Varese, Italy
- Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
| | - Roberto Acampora
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neurology and Stroke-Unit, Hospital Ospedale del Mare, Naples, Italy
| | - Davide Salmi
- Anesthesia and Intensive Care Unit, Biotechnology and Life Sciences Department, University of Insubria, Varese, Italy
| | - Ingrid Andrea Ilie
- Department of Life Sciences and Biotechnology, School of Biology, University of Ferrara, Ferrara, Italy
| | - Nadia Pagnoncelli
- Psychiatry Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Francesco Germano
- Neurology Unit, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Greta Gandolfi
- Anesthesia and Intensive Care Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Melvin Sanicas
- Clinical – Vaccines, Clover Biopharmaceuticals, Zurich, Switzerland
| | - Adam Seed
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Clinical Infection Microbiology and Neuroimmunology, Institute of Infection, Veterinary and Ecological Science, Liverpool, UK
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
| | - Benedict Daniel Michael
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Clinical Infection Microbiology and Neuroimmunology, Institute of Infection, Veterinary and Ecological Science, Liverpool, UK
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
| | - Simone Donati
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Claudio Azzolini
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Francesco Lanfranchi
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
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Bariş Üçer M, Cevher S. How does Covid-19 affect the choroidal structures at the early post-infectious period? J Fr Ophtalmol 2023; 46:106-113. [PMID: 36585332 PMCID: PMC9771749 DOI: 10.1016/j.jfo.2022.08.003] [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: 06/11/2022] [Revised: 07/30/2022] [Accepted: 08/10/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate choroidal thickness (CT) and choroidal vascularity index (CVI) in patients recovered from COVID-19 using enhanced depth imaging optical coherence tomography in the early postinfectious period. METHODS Sixty-five patients recovered from COVID-19 and 72 healthy subjects were included in the study. A full ophthalmic examination including best-corrected visual acuity (BCVA), slit lamp biomicroscopy, and dilated fundus examination was performed. CT was measured at 3 points as follows: subfoveal, 1000μm nasal and temporal to the fovea. The total choroidal area (TCA), luminal area (LA), stromal area (SA), and CVI were measured with Image-J. RESULTS The mean age was 39.09±11.27 years in the COVID-19 group and 39.61±11.43 years in the control group. The mean time from the first positive RT-PCR was 49.54±26.82 days (range 18-120) in the COVID-19 group. No statistically significant difference was detected between the groups with regard to axial length, spherical equivalent, and BCVA (all P>0.05). CT was found to be lower in the COVID-19 group compared to the control group in all quadrants, but this difference was not significant (all P>0.05). The mean TCA, LA, and CVI were statistically significantly reduced in the COVID-19 group (all P<0.001); however, SA showed no statistically significant difference (P=0.064). CONCLUSIONS In asymptomatic or mild COVID-19, CVI and LA decrease significantly, while CT thins in the early postinfectious period but not significantly.
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Shahri SHG, Abrishami M, Shayanfar H, Khazaei S. Bilateral anterior ischemic optic neuropathy and choroidal ischemia in a patient with COVID-19 infection. Clin Case Rep 2023; 11:e6834. [PMID: 36703768 PMCID: PMC9869642 DOI: 10.1002/ccr3.6834] [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: 09/09/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 01/25/2023] Open
Abstract
A 57-year-old male known case of diabetes mellitus presented with gradually bilateral decreased vision accompanied by ocular pain two weeks after diagnosis of SARS-CoV-2 infection. The results of examination and imaging were indicative of bilateral anterior ischemic optic neuropathy (AION) and massive choroidal ischemia, which may be associated with SARS-CoV-2-induced damages, including endothelial damage, hypercoagulable state, and hypoxia.
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Affiliation(s)
| | - Mojtaba Abrishami
- Eye Research CenterMashhad University of Medical SciencesMashhadIran
| | - Helia Shayanfar
- Eye Research CenterMashhad University of Medical SciencesMashhadIran
| | - Sahel Khazaei
- Eye Research CenterMashhad University of Medical SciencesMashhadIran
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Muacevic A, Adler JR, Ture Yuce Z, Sevim DG, Temizyurek O, Polat OA, Horozoglu F. The Effect of Corticosteroid Therapy on Choroidal Thickness in Patients With Covid-19 Infection: A Prospective, Comparative, and Observational Study. Cureus 2022; 14:e32835. [PMID: 36699792 PMCID: PMC9870188 DOI: 10.7759/cureus.32835] [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] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (Covid-19) has many different ocular manifestations. This study evaluates the effects of the disease and the steroid used in this disease on ocular structures. PURPOSE To evaluate the effects of Covid-19 and the steroids used in the treatment of severe infection on ocular structures and choroidal thickness. METHODS This prospective study included 76 eyes of 76 patients who were hospitalized due to Covid-19 and 30 eyes of 30 healthy volunteering controls. Group I included 35 eyes who were hospitalized due to moderate-to-severe involvement that received steroid treatment, group II included 41 eyes with moderate involvement that did not require steroid treatment, and group III included 30 eyes with age- and gender-matched control subjects. Ophthalmological examination and imaging results of the patients obtained in the third week and third month after the diagnosis were compared between the groups. RESULTS Mean age of all participants was 40.2 ± 6.1 years. In the third week after the diagnosis of Covid-19, choroidal thickness in all regions (subfoveal, nasal, and temporal) was significantly greater in group I than in group II (for all, p<0.001). Moreover, choroidal thicknesses were significantly higher in group I and group II than in the control group (for all, p<0.001). In the third month, all the groups had similar choroidal thickness values (for subfoveal, nasal, and temporal; p=0.058, p=0.111, p=0.079, respectively). CONCLUSION Our findings showed that Covid-19 infection causes choroidal thickening by affecting the choroidal layer and that steroid treatment further increases this thickness in the acute period. In addition, the reversal of this thickening to the normal level within a period of three months indicates that the effect of the disease on the choroid is reversible.
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Gül FC, Timurkaan ES. Evaluation of choroidal thickness with OCT in COVID-19 patients with high D-dimer levels. Sci Rep 2022; 12:16826. [PMID: 36258025 PMCID: PMC9579170 DOI: 10.1038/s41598-022-21579-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/29/2022] [Indexed: 12/15/2022] Open
Abstract
To evaluate retinal and choroidal thickness with optical coherence tomography (OCT) to detect retinal and choroidal pathologies in coronavirus disease 2019 (COVID-19) patients with high D-dimer levels. Thirty patients who were hospitalized in the intensive care unit due to severe acute respiratory syndrome coronavirus 2 and whose D-dimer levels were high during this period, who applied to the internal medicine outpatient clinic between 15 and 30 days after discharge, and 30 healthy volunteers with similar age and gender as the control group was included in the study. After full ophthalmological examination, central foveal and choroidal thicknesses were evaluated using optical coherence tomography. Statistical analysis of the study data demonstrated that there was no significant difference between the groups in terms of age or gender (p > 0.05). There was also no statistically significant difference between the groups in terms of central foveal thickness, central choroidal thickness, or nasal 500, nasal 1500, temporal 500, or temporal 500 micron distances (p > 0.05 for all parameters). Choroidal and retinal vascular thicknesses were not affected in the short term in COVID-19 patients hospitalized in the intensive care unit.
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Affiliation(s)
- Fatih Cem Gül
- Universal Eye Center, Ophthalmology Clinic, Elazig, Turkey.
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