Topic Editors

Medical Doctor, Ophthalmologist, Research Fellow, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
Department of Ophthalmology, University of Magna Graecia, Catanzaro 88100, Italy
Department of Ophthalmology, University Magna Gaecia of Catanzaro, Catanzaro, Italy

COVID-19 and the Eye: Impact of Pandemic on Clinical, Surgical and Research Activities in Ophthalmology

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closed (31 October 2022)
Manuscript submission deadline
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Topic Information

Dear Colleagues,

Nowadays ophthalmic practice widely depend on optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A), which are objective, reliable, and repeatable structural tests for both early diagnosis and detection of the progression of various ocular diseases. Regarding the imaging of the anterior pole of the eye, OCT is mainly used the study of cornea, anterior chamber including the angle and crystalline lens, while OCT-A for cornea, iris, sclera and conjunctiva. Regarding the imaging of the posterior pole of the eye, although clinical applications of OCT and OCT-A embrace the entire spectrum of chorioretinal diseases, the most promising fields are diabetic retinopathy, retinal vascular occlusion, inflammatory diseases, macular telangiectasia, and age-related macular degeneration.

The COVID-19 pandemic has profoundly impacted the delivery of medical care over all the world. Ophthalmologists have been particularly impacted by the pandemic as the majority of ophthalmic surgical procedures are elective and a significant proportion of ophthalmologists’ patients are older, with greater risk for comorbidities.

This Topic will focus on the latest evidence and impact of COVID-19 on Ophthalmology practice. Many changes in practices during this pandemic will be accelerated and sustained and will become part of the new normal after the COVID-19 pandemic.

Dr. Adriano Carnevali
Prof. Vincenzo Scorcia
Prof. Dr. Giuseppe Giannaccare
Topic Editors

Keywords

  • optical coherence tomography
  • optical coherence tomography angiography
  • retinal disease
  • maculopathy
  • retinal imaging
  • diabetic retinopathy
  • age-related macular degeneration
  • central serous chorioretinopathy
  • retinal vein occlusion
  • macular dystrophies
  • choroidal neovascularization
  • pathologic myopia
  • optic nerve
  • COVID-19 and the eye

Participating Journals

Journal Name Impact Factor CiteScore Launched Year First Decision (median) APC
Applied Sciences
applsci
2.5 5.3 2011 17.8 Days CHF 2400
Journal of Clinical Medicine
jcm
3.0 5.7 2012 17.3 Days CHF 2600
Biomedicines
biomedicines
3.9 5.2 2013 15.3 Days CHF 2600
Viruses
viruses
3.8 7.3 2009 16.1 Days CHF 2600
Diagnostics
diagnostics
3.0 4.7 2011 20.5 Days CHF 2600

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Published Papers (17 papers)

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6 pages, 2066 KiB  
Interesting Images
Post-Traumatic Cilia Remaining Inert in the Posterior Chamber for 50 Years
by Cosmin Adrian Teodoru, Mihai Dan Roman, Adrian Hașegan, Claudiu Matei, Cosmin Mohor, Mihnea Munteanu, Mihaela Laura Vică, Horea Vladi Matei, Horia Stanca, Maria-Emilia Cerghedean-Florea and Horațiu Dura
Diagnostics 2023, 13(9), 1575; https://doi.org/10.3390/diagnostics13091575 - 28 Apr 2023
Cited by 1 | Viewed by 1389
Abstract
Intraocular foreign body injuries (IOFB) can lead to a number of intraocular pathologies; the visual results depend on the mechanism of the injury, the type of foreign body and the subsequent complications. The presence of intraocular cilia (eye lashes) following penetrating injury or [...] Read more.
Intraocular foreign body injuries (IOFB) can lead to a number of intraocular pathologies; the visual results depend on the mechanism of the injury, the type of foreign body and the subsequent complications. The presence of intraocular cilia (eye lashes) following penetrating injury or surgical intervention is uncommon. In the present paper, we present a case of a 58-year-old woman with a history of eye trauma and a perforated corneal wound in the left eye that occurred 50 years ago. On the ophthalmological exam we noticed in the anterior chamber a straight linear extension, resembling cilia, extending behind the iris. The patient reports that it appeared during COVID-19 infection, after repeated episodes of coughing. After a follow-up period, we decided to remove the eyelash; 24 h after surgery, the patient complained of severe eye pain. Intraocular pressure (IOP) in LE was 54 mmHg. The slit-lamp examination showed perikeratic congestion, corneal edema and mydriasis. Eye hypotensive treatment was started immediately and the patient’s general condition slightly improved. Intraocular cilia can be tolerated for many years without causing any ocular reaction. The decision for surgical intervention must be taken according to the individual needs of the patient and his ocular characteristics with careful pre- and post-operative follow up. Full article
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15 pages, 1153 KiB  
Article
Impact of COVID-19 Confinement on Quality of Life of Patients with Age-Related Macular Degeneration: A Two-Wave Panel Study
by María R. Sanabria, Paola S. Calles-Monar, Ana M. Alonso-Tarancón, Rosa M. Coco-Martín and Agustín Mayo-Iscar
J. Clin. Med. 2023, 12(6), 2394; https://doi.org/10.3390/jcm12062394 - 20 Mar 2023
Cited by 2 | Viewed by 1664
Abstract
Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. Intravitreal injections of antiangiogenic agents (anti-VEGF) can stop vision loss in the neovascular form of the disease (nAMD). The aim of this study was to assess the general health-related quality [...] Read more.
Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. Intravitreal injections of antiangiogenic agents (anti-VEGF) can stop vision loss in the neovascular form of the disease (nAMD). The aim of this study was to assess the general health-related quality of life (HRQoL) in a cohort of patients with nAMD treated with intravitreal anti-VEGF injections and to detesrmine to what extent their HRQoL was affected by COVID-19. This was an observational, analytical, and longitudinal study performed with a two-wave panel survey. Clinical outcomes, HRQoL, and tangible support were evaluated. In the final survey, changes in living conditions and medical visits due to the COVID-19 pandemic were also examined. Of the 102 patients initially interviewed in the before-COVID survey, 24 were lost after 30 months of follow-up. In the initial assessment, the mean health index was 0.73 ± 0.2. The EQ VAS score worsened at the final survey (p = 0.048). Patients needing treatment in both eyes (p = 0.007) and with lower levels of bilateral visual acuity (p = 0.018) reported an increase in social support at the final survey. In conclusion, patients perceived a worsening in HRQoL after confinement. However, patients enjoyed good social support that improved in the after-COVID survey. Full article
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13 pages, 1500 KiB  
Article
Conjunctival Swabs Reveal Higher Detection Rate Compared to Schirmer Strips for SARS-CoV-2 RNA Detection in Tears of Hospitalized COVID-19 Patients
by Luís Expedito Sabage, Young Joo Sun, Julian Wolf, Josmar Sabage, Alessandra Mazzo, Carlos Ferreira Santos, Vinit B. Mahajan and Luiz Fernando Manzoni Lourençone
J. Clin. Med. 2022, 11(23), 6929; https://doi.org/10.3390/jcm11236929 - 24 Nov 2022
Cited by 3 | Viewed by 5454
Abstract
Purpose: To determine the prevalence of SARS-CoV-2 in tear samples and to investigate whether it correlates with ocular findings and patients’ prognosis in Brazil. Methods: Tears were collected using Schirmer strips (SS) and conjunctival swabs (CS) from patients hospitalized with laboratory-confirmed SARS-CoV-2 infection. [...] Read more.
Purpose: To determine the prevalence of SARS-CoV-2 in tear samples and to investigate whether it correlates with ocular findings and patients’ prognosis in Brazil. Methods: Tears were collected using Schirmer strips (SS) and conjunctival swabs (CS) from patients hospitalized with laboratory-confirmed SARS-CoV-2 infection. Samples were analyzed using qRT-PCR. Demographic and clinical data, ocular symptoms, and Schirmer tests (ST) were collected from patients. Charlson Comorbidity Index (CCI) was used to rate comorbidities, and patients were monitored until hospital discharge or death. Results: There were 61 hospitalized patients, 33 of which were diagnosed with COVID-19. Within the confirmed COVID-19 patients, SARS-CoV-2 was detected in 18.2% (n = 6) of CS and 12.1% (n = 4) of SS samples. Subjective and objective parameters for dry eye syndrome (e.g., ST COVID-19: 8.3 ± 6.4mm, non-COVID-19: 8.9 ± 6.6mm, p > 0.05) were comparable between COVID-19 (n = 33) and non-COVID-19 patients (n = 28). Among the 16 COVID-19 patients exhibiting ocular symptoms, only tearing was reported significantly more frequently when tear samples were positive for SARS-CoV-2 (p < 0.05). Strikingly, patients whose tears tested positive for SARS-CoV-2 had significantly inferior CCI (pos.: 34.0 ± 31.8%, neg.: 67.6 ± 36.4%, p < 0.05) and higher mortality rates (pos.: 50.0%, neg.: 7.4%, p < 0.01). Conclusions: SARS-CoV-2 was detected with a prevalence of 18.2% on the ocular surface. Decreased CCI and increased mortality rate in the positive tear group suggests that viral detection may relate to prognosis and highlight the need of personal protective measures for healthcare professionals. Most of the patients, regardless of COVID-19 diagnosis, had low tear production and eye discomfort, possibly pointing to the need for artificial tear use during hospitalization. Full article
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10 pages, 660 KiB  
Article
Long-Term Consequences of COVID-19 Lockdown in Neovascular AMD Patients in Spain: Structural and Functional Outcomes after 1 Year of Standard Follow-Up and Treatment
by Daniela Rego-Lorca, Alicia Valverde-Megías, José Ignacio Fernández-Vigo, Carlos Oribio-Quinto, Antonio Murciano-Cespedosa, Julia Sánchez-Quirós, Juan Donate-López and Julián García-Feijóo
J. Clin. Med. 2022, 11(17), 5063; https://doi.org/10.3390/jcm11175063 - 28 Aug 2022
Cited by 6 | Viewed by 1826
Abstract
Consequences of the COVID-19 pandemic on medical care have been extensively analyzed. Specifically, in ophthalmology practice, patients suffering age-related macular degeneration (AMD) represent one of the most affected subgroups. After reporting the acute consequences of treatment suspension in neovascular AMD, we have now [...] Read more.
Consequences of the COVID-19 pandemic on medical care have been extensively analyzed. Specifically, in ophthalmology practice, patients suffering age-related macular degeneration (AMD) represent one of the most affected subgroups. After reporting the acute consequences of treatment suspension in neovascular AMD, we have now evaluated these same 242 patients (270 eyes) to assess if prior functional and anatomical situations can be restored after twelve months of regular follow-up and treatment. We compared data from visits before COVID-19 outbreak and the first visit after lockdown with data obtained in subsequent visits, until one year of follow-up was achieved. For each patient, rate of visual loss per year before COVID-19 pandemic, considered “natural history of treated AMD”, was calculated. This rate of visual loss significantly increased during the lockdown period and now, after twelve months of regular follow-up, is still higher than before COVID outbreak (3.1 vs. 1.6 ETDRS letters/year, p < 0.01). Percentage of OCT images showing active disease is now lower than before the lockdown period (51% vs. 65.3%, p = 0.0017). Although anatomic deterioration, regarding signs of active disease, can be apparently fully restored, our results suggest that functional consequences of temporary anti-VEGF treatment suspension are not entirely reversible after 12 months of treatment, as BCVA remains lower and visual loss rate is still higher than before the COVID-19 pandemic. Full article
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13 pages, 1111 KiB  
Article
Eye Infection with SARS-CoV-2 as a Route to Systemic Immunization?
by Norbert Schrage, Joel Blomet, Frank Holzer, A. Tromme, F. Ectors and Daniel Desmecht
Viruses 2022, 14(7), 1447; https://doi.org/10.3390/v14071447 - 30 Jun 2022
Cited by 5 | Viewed by 1917
Abstract
Infectious diseases of the conjunctiva and cornea usually leave behind both broad local and systemic immunity. Case reports of SARS-CoV-2-positive conjunctivitis with subsequent systemic immunity suggest a new route of immunization preventing the primary infection of the airways. Material and Methods: A total [...] Read more.
Infectious diseases of the conjunctiva and cornea usually leave behind both broad local and systemic immunity. Case reports of SARS-CoV-2-positive conjunctivitis with subsequent systemic immunity suggest a new route of immunization preventing the primary infection of the airways. Material and Methods: A total of 24 Syrian field hamsters were treated. In systematic animal experiments, we infected the eyes of n = 8 animals (group 1) and the airways of another n = 8 animals (group 2) with SARS-CoV-2 (Wuhan type); n = 8 hamsters served as controls (group 3). The weight development of the animals was recorded. After two weeks of observation of disease symptoms, all animals were re-exposed to SARS-CoV-2 in the respiratory tract (challenge) to determine whether immunity to the virus had been achieved. Results: The epi-ocularly infected animals (group 1) showed no clinically visible disease during the ocular infection phase. At most, there was a slightly reduced weight gain compared to the control group (group 3), while the respiratory infected animals (group 2) all lost weight, became lethargic, and slowly recovered after two weeks. After the challenge, none of the animals in groups 1 and 2 became ill again. The animals in the negative control (group 3) all became ill. Cytotoxic antibodies were detectable in the blood of the infected groups before and after challenge, with higher titers in the epi-ocularly infected animals. Conclusion: By epi-ocular infection with SARS-CoV-2, the development of systemic immunity with formation of cytotoxic antibodies without severe general disease could be observed in the experimental animals, which did not induce any more disease upon a second infection in the respiratory tract. Therefore, it can be concluded that a purely epi-ocular infection with SARS-CoV2 only induces a weak disease pattern followed by systemic immunity. Full article
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13 pages, 1424 KiB  
Article
Follow up of the Humoral Response in Healthcare Workers after the Administration of Two Dose of the Anti SARS-CoV-2 Vaccines—Effectiveness in Delta Variant Breakthrough Infections
by Gema Fernández-Rivas, Jaume Barallat, Bibiana Quirant-Sánchez, Victoria González, María Doladé, Eva Martinez-Caceres, Monica Piña, Joan Matllo, Ignacio Blanco and Pere-Joan Cardona
Viruses 2022, 14(7), 1385; https://doi.org/10.3390/v14071385 - 24 Jun 2022
Cited by 2 | Viewed by 2003
Abstract
The implementation of vaccination among healthcare workers (HCWs) allowed the management of the pandemic in a manner that differed from that in the first waves. It has been demonstrated that the mRNA vaccines elicit good humoral responses but that there are still breakthrough [...] Read more.
The implementation of vaccination among healthcare workers (HCWs) allowed the management of the pandemic in a manner that differed from that in the first waves. It has been demonstrated that the mRNA vaccines elicit good humoral responses but that there are still breakthrough infections. In summer 2021, a fifth wave emerged, despite the good coverage of HCWs in Spain. We aimed to study the SARS-CoV-2 IgG antibody levels as a marker to predict the possibility of Delta variant infections after vaccination after a seroepidemiological campaign. Of the 5000 participants, a total of 4902 (98.04%) showed a positive result in the serological anti-S test and only 98 (1.96%) were negative. Among the 4368 fully vaccinated participants, only in five cases was the serology negative. Of the total number of participants that received antibody results during the study, 162 were PCR positive in the subsequent two months. Among these, 151 were fully vaccinated (two doses). Significant differences between antibody BAU/mL levels were found between PCR positive and non-PCR positive participants (p < 0.01). The median of BAU/mL was higher in those vaccinated patients with no infection (1260 BAU/mL; 465–2080) versus infected patients (661 BAU/mL; 361–2080). These data support the idea that vaccines play an important role in the control of the pandemic, especially among HCWs at the time of the Delta variant circulation. More studies with other variants of concern must be performed in order to establish a correlation between the levels of IgG and the new infections. Full article
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12 pages, 1496 KiB  
Article
Retinal Microvascular Changes in COVID-19 Bilateral Pneumonia Based on Optical Coherence Tomography Angiography
by Magdalena Kal, Mateusz Winiarczyk, Elżbieta Cieśla, Bernadetta Płatkowska-Adamska, Anna Walczyk, Michał Biskup, Paweł Pabjan, Stanisław Głuszek, Dominik Odrobina, Jerzy Mackiewicz and Dorota Zarębska-Michaluk
J. Clin. Med. 2022, 11(13), 3621; https://doi.org/10.3390/jcm11133621 - 23 Jun 2022
Cited by 12 | Viewed by 1883
Abstract
The purpose of this study was to evaluate retinal and choroidal microvascular alterations with optical coherence tomography angiography (OCTA) in COVID-19 patients hospitalized because of bilateral pneumonia caused by SARS-CoV-2. The vessel density (VD) and foveal avascular zone (FAZ) of 63 patients with [...] Read more.
The purpose of this study was to evaluate retinal and choroidal microvascular alterations with optical coherence tomography angiography (OCTA) in COVID-19 patients hospitalized because of bilateral pneumonia caused by SARS-CoV-2. The vessel density (VD) and foveal avascular zone (FAZ) of 63 patients with SARS-CoV-2 pneumonia who had positive polymerase chain reaction (PCR) tests and who recovered after receiving treatment and 45 healthy age- and gender-matched controls were evaluated and compared using OCTA in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). The VD was also estimated in both groups in the choriocapillaris (CC). In COVID-19 patients, there was a statistically significant difference between the patients and a control group in both superficial (FAZs) and deep (FAZd) avascular zone (p = 0.000). The VD was significantly lower in the foveal area in choriocapillaris (p = 0.046). There were no statistically significant changes in the VD in the superior, inferior, nasal, and temporal quadrants in superficial and deep plexus, or in the choriocapillaris. The VD was not significantly lower in the foveal area in superficial or deep plexus. COVID-19 may affect the retinal vasculature, causing ischemia, enlargement of the FAZ, and lowering of the VD in the choriocapillaris area. Routine ophthalmic examination after SARS-CoV-2 infection should be considered in the course of post-infectious rehabilitation. Full article
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2 pages, 186 KiB  
Editorial
COVID-19 and the Eye: Impact of COVID-19 Pandemic on Clinical, Surgical and Research Activities in Ophthalmology
by Giuseppe Giannaccare, Andrea Taloni, Vincenzo Scorcia and Adriano Carnevali
Appl. Sci. 2022, 12(10), 5180; https://doi.org/10.3390/app12105180 - 20 May 2022
Viewed by 1506
Abstract
Since the outbreak of the novel SARS-CoV-2 virus in early 2020, globally, more than 500 million cumulative cases of COVID-19 have been confirmed as of May 2022, resulting in about 6 million deaths [...] Full article
17 pages, 3028 KiB  
Article
Altered Ocular Surface Health Status and Tear Film Immune Profile Due to Prolonged Daily Mask Wear in Health Care Workers
by Sharon D’Souza, Tanuja Vaidya, Archana Padmanabhan Nair, Rohit Shetty, Nimisha Rajiv Kumar, Anadi Bisht, Trailokyanath Panigrahi, Tejal S. J, Pooja Khamar, Mor M. Dickman, Ruchika Agrawal, Sanjay Mahajan, Sneha Sengupta, Rudy M. M. A. Nuijts, Swaminathan Sethu and Arkasubhra Ghosh
Biomedicines 2022, 10(5), 1160; https://doi.org/10.3390/biomedicines10051160 - 18 May 2022
Cited by 13 | Viewed by 2798
Abstract
Prolonged daily face mask wearing over several months might affect health of the ocular surface and is reported to be associated with complaints of discomfort and dry-eye-like symptoms. We studied the ocular surface clinical parameters, tear soluble factors and immune cell proportions in [...] Read more.
Prolonged daily face mask wearing over several months might affect health of the ocular surface and is reported to be associated with complaints of discomfort and dry-eye-like symptoms. We studied the ocular surface clinical parameters, tear soluble factors and immune cell proportions in ophthalmologists practicing within similar environmental conditions (n = 17) at two time points: pre-face-mask period (Pre-FM; end of 2019) and post-face-mask-wearing period (Post-FM; during 2020 COVID-19 pandemic), with continuous (~8 h/day) mask wear. A significant increase in ocular surface disease index (OSDI) scores without changes in tear breakup time (TBUT), Schirmer’s test 1 (ST1) and objective scatter index (OSI) was observed Post-FM. Tear soluble factors (increased—IL-1β, IL-33, IFNβ, NGF, BDNF, LIF and TSLP; decreased—IL-12, IL-13, HGF and VEGF-A) and mucins (MUC5AC) were significantly altered Post-FM. Ex vivo, human donor and corneoscleral explant cultures under elevated CO2 stress revealed that the molecular profile, particularly mucin expression, was similar to the Post-FM tear molecular profile, suggesting hypercapnia is a potential contributor to ocular surface discomfort. Among the immune cell subsets determined from ocular surface wash samples, significantly higher proportions of leukocytes and natural killer T cells were observed in Post-FM compared to Pre-FM. Therefore, it is important to note that the clinical parameters, tear film quality, tear molecular factors and immune cells profile observed in prolonged mask-wear-associated ocular surface discomfort were distinct from dry eye disease or other common ocular surface conditions. These observations are important for differential diagnosis as well as selection of appropriate ocular surface treatment in such subjects. Full article
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9 pages, 897 KiB  
Article
Retinal Manifestations in Patients with COVID-19: A Prospective Cohort Study
by Eleonora Riotto, Vladimir Mégevand, Alexis Mégevand, Christophe Marti, Jerome Pugin, Alexandros N. Stangos, Leonardo Marconi Archinto and Gordana Sunaric Mégevand
J. Clin. Med. 2022, 11(7), 1828; https://doi.org/10.3390/jcm11071828 - 25 Mar 2022
Cited by 8 | Viewed by 6254
Abstract
The recent outbreak of the Coronavirus SARS-CoV-2 has been declared a worldwide pandemic. Within various multi-organ involvement, several ocular manifestations have been described, such as conjunctivitis and retinopathy. The prevalence and severity of retinal lesions and their relation to the severity of the [...] Read more.
The recent outbreak of the Coronavirus SARS-CoV-2 has been declared a worldwide pandemic. Within various multi-organ involvement, several ocular manifestations have been described, such as conjunctivitis and retinopathy. The prevalence and severity of retinal lesions and their relation to the severity of the systemic disease are unknown. We performed a prospective, observational study on 172 consecutively hospitalized patients with acute confirmed COVID-19 infection. All patients underwent screening widefield fundus photography at the time of hospital admission. Despite no ocular or vision-related symptoms, we found cotton wool spots (CWS) and/or hemorrhages in 19/172 patients (11%). Diabetes history, overweight, and elevated C-reactive protein were more frequently observed among patients with retinal abnormalities, while a history of systemic hypertension was more frequently observed among patients without retinal findings. At a 3-month follow-up visit, CWS had subsided in all patients. Full article
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9 pages, 710 KiB  
Article
Impact of the Coronavirus Disease 2019 Pandemic on the Ophthalmology Department
by Ha-Eun Sim, Kyeong-Do Jeong and Je-Hyung Hwang
J. Clin. Med. 2022, 11(6), 1722; https://doi.org/10.3390/jcm11061722 - 20 Mar 2022
Cited by 4 | Viewed by 1813
Abstract
We aimed to evaluate the effects of the coronavirus disease (COVID-19) pandemic on the Ophthalmology Department. This study was based on data collected between January 2019 and November 2021. We divided patients scheduled for eye care during pre-COVID-19 (January–December 2019), early COVID-19 (January–December [...] Read more.
We aimed to evaluate the effects of the coronavirus disease (COVID-19) pandemic on the Ophthalmology Department. This study was based on data collected between January 2019 and November 2021. We divided patients scheduled for eye care during pre-COVID-19 (January–December 2019), early COVID-19 (January–December 2020), and late COVID-19 (January–November 2021) periods. Changes in the outpatient cancellation rate in each department were analyzed and compared in the pre-, early, and late periods. The basic information of cancellation and reason for not visiting the clinic were also analyzed. Overall, 121,042 patients were scheduled to visit the Sanggye Paik Hospital Ophthalmology Department. The overall cancellation rate was 19.13% during pre-COVID-19, 24.13% during early COVID-19, and 17.34% during late COVID-19. The reasons for not visiting the clinic included hospital, patient, and contact factors; hospitalization in other departments and hospitals; and death. The Strabismus/Pediatric Ophthalmology Department showed the highest cancellation rate of 24.21% over three years. There were no significant differences in the causes of hospital visits by period. The COVID-19 pandemic has caused an overall decrease in the number of ophthalmic outpatients. However, after about a year, the number of outpatients in these departments recovered to the level before the COVID-19 outbreak. Full article
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14 pages, 261 KiB  
Article
Uveitis and Other Ocular Complications Following COVID-19 Vaccination
by Elena Bolletta, Danilo Iannetta, Valentina Mastrofilippo, Luca De Simone, Fabrizio Gozzi, Stefania Croci, Martina Bonacini, Lucia Belloni, Alessandro Zerbini, Chantal Adani, Luigi Fontana, Carlo Salvarani and Luca Cimino
J. Clin. Med. 2021, 10(24), 5960; https://doi.org/10.3390/jcm10245960 - 19 Dec 2021
Cited by 96 | Viewed by 7419
Abstract
Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other ocular complications following COVID-19 vaccination. The study included 42 eyes of 34 patients (20 females, 14 males), with a [...] Read more.
Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other ocular complications following COVID-19 vaccination. The study included 42 eyes of 34 patients (20 females, 14 males), with a mean age of 49.8 years (range 18–83 years). The cases reported were three herpetic keratitis, two anterior scleritis, five anterior uveitis (AU), three toxoplasma retinochoroiditis, two Vogt-Koyanagi-Harada (VKH) disease reactivations, two pars planitis, two retinal vasculitis, one bilateral panuveitis in new-onset Behçet’s disease, three multiple evanescent white dot syndromes (MEWDS), one acute macular neuroretinopathy (AMN), five retinal vein occlusions (RVO), one non-arteritic ischemic optic neuropathy (NAION), three activations of quiescent choroidal neovascularization (CNV) secondary to myopia or uveitis, and one central serous chorioretinopathy (CSCR). Mean time between vaccination and ocular complication onset was 9.4 days (range 1–30 days). Twenty-three cases occurred after Pfizer-BioNTech vaccination (BNT162b2 mRNA), 7 after Oxford-AstraZeneca vaccine (ChAdOx1 nCoV-19), 3 after ModernaTX vaccination (mRNA-1273), and 1 after Janssen Johnson & Johnson vaccine (Ad26.COV2). Uveitis and other ocular complications may develop after the administration of COVID-19 vaccine. Full article
10 pages, 2416 KiB  
Article
Did the COVID-19 Pandemic Increase the Incidence of Acute Macular Neuroretinopathy?
by Georges Azar, Sophie Bonnin, Vivien Vasseur, Céline Faure, Flore Salviat, Catherine Vignal Clermont, Cherif Titah, Selim Farès, Elise Boulanger, Sabine Derrien, Aude Couturier, Amélie Duvilliers, Anthony Manassero, Rabih Hage, Ramin Tadayoni, Francine Behar-Cohen and Martine Mauget-Faÿsse
J. Clin. Med. 2021, 10(21), 5038; https://doi.org/10.3390/jcm10215038 - 28 Oct 2021
Cited by 44 | Viewed by 4237
Abstract
Background: Acute macular neuroretinopathy (AMN) is an increasingly diagnosed disorder associated with several diseases. The aim of this study was to report the incidence of AMN cases diagnosed during the 2020 coronavirus disease 2019 (COVID-19) pandemic year in a French hospital, and to [...] Read more.
Background: Acute macular neuroretinopathy (AMN) is an increasingly diagnosed disorder associated with several diseases. The aim of this study was to report the incidence of AMN cases diagnosed during the 2020 coronavirus disease 2019 (COVID-19) pandemic year in a French hospital, and to describe their different forms. Methods: All patients diagnosed between 2019 and 2020, in Paris Rothschild Foundation Hospital, with AMN, paracentral acute middle maculopathy (PAMM) and multiple evanescent white dot syndrome (MEWDS) were retrospectively collected using the software Ophtalmoquery® (Corilus, V1.86.0018, 9050 Gand, Belgium). Systemic and ophthalmological data from AMN patients were analyzed. Results: Eleven patients were diagnosed with AMN in 2020 vs. only one patient reported in 2019. The incidence of AMN significantly increased from 0.66/100,000 visits in 2019 to 8.97/100,000 visits in 2020 (p = 0.001), whereas the incidence of PAMM and MEWDS remained unchanged. Four (36%) of these AMN patients were tested for COVID-19 and received positive polymerase chain reaction (PCR) tests. Conclusions: The incidence of AMN cases increased significantly in our institution in 2020, which was the year of the COVID-19 pandemic. All AMN-tested patients received a positive COVID PCR test, suggesting a possible causative link. According to the different clinical presentations, AMN may reflect different severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pathogenic mechanisms. Full article
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10 pages, 8338 KiB  
Article
Evaluation of Macular Retinal Vessels and Histological Changes in Two Cases of COVID-19
by Maria Hernandez, Jorge González-Zamora, Sergio Recalde, Maite Moreno-Orduña, Valentina Bilbao-Malavé, Manuel Saenz de Viteri, Manuel F. Landecho, Patricia Fernandez-Robredo and Alfredo García-Layana
Biomedicines 2021, 9(11), 1546; https://doi.org/10.3390/biomedicines9111546 - 26 Oct 2021
Cited by 4 | Viewed by 2186
Abstract
The purpose of this study was to assess vascular and histological alterations in two COVID-19 and three control post-mortem retinas. The macular areas of flat-mounted samples were processed for immunofluorescence. Lectin and collagen IV positive vessels were captured under confocal microscopy, and endothelium [...] Read more.
The purpose of this study was to assess vascular and histological alterations in two COVID-19 and three control post-mortem retinas. The macular areas of flat-mounted samples were processed for immunofluorescence. Lectin and collagen IV positive vessels were captured under confocal microscopy, and endothelium loss and tortuosity were analyzed. Expression of ACE2 (angiotensin-converting enzyme 2) (the receptor for SARS-CoV-2), Iba1 (ionized calcium-binding adaptor molecule 1) and GFAP (glial fibrillary acidic protein) were quantified in retinal sections. The number of lectin vessels in COVID-19 retinas decreased by 27% compared to the control (p < 0.01) and the tortuosity increased in COVID-19 retinas (7.3 ± 0.2) vs. control retinas (6.8 ± 0.07) (p < 0.05). Immunofluorescence analysis revealed an increase in ACE2 (2.3 ± 1.3 vs. 1.0 ± 0.1; p < 0.0001) and Iba1 expression (3.06 ± 0.6 vs. 1.0 ± 0.1; p < 0.01) in COVID-19 sections whereas no changes in GFAP were observed. Analysis of the COVID-19 macular retinal tissue suggested that endothelial cells are a preferential target of SARS-CoV-2 with subsequent changes through their ACE2 receptor expression and morphology. Thus, microglial activation was hyperactive when facing an ensuing immunological challenge after SARS-CoV-2 infection. Full article
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12 pages, 2835 KiB  
Article
COVID-19 Associated Choroidopathy
by Youssef Abdelmassih, Georges Azar, Sophie Bonnin, Claire Scemama Timsit, Vivien Vasseur, Richard F. Spaide, Francine Behar-Cohen and Martine Mauget-Faysse
J. Clin. Med. 2021, 10(20), 4686; https://doi.org/10.3390/jcm10204686 - 13 Oct 2021
Cited by 7 | Viewed by 2339
Abstract
The aim of the study is to report on the indocyanine green angiography (ICGA) and OCT findings in patients hospitalized for severe COVID infection. In this observational prospective monocentric cohort study, we included patients hospitalized for severe COVID infection. The main outcomes were [...] Read more.
The aim of the study is to report on the indocyanine green angiography (ICGA) and OCT findings in patients hospitalized for severe COVID infection. In this observational prospective monocentric cohort study, we included patients hospitalized for severe COVID infection. The main outcomes were ICGA and OCT findings. A total of 14 patients with a mean age of 58.2 ± 11.4 years and a male predominance (9/14 patients; 64%) were included. The main ICGA findings included hypofluorescent spots in 19 eyes (68%), intervortex shunts in 10 eyes (36%), and characteristic “hemangioma-like” lesions in five eyes (18%). “Hemangioma-like” lesions were both unique and unilateral, and showed no washout on the late phase of the angiogram. The main OCT findings included focal choroidal thickening in seven eyes (25%), caverns in six eyes (21%) and paracentral acute middle maculopathy lesions in one eye (4%). All patients hospitalized for severe COVID infection had anomalies on ICGA and OCT. Lesions to both retinal and choroidal vasculature were found. These anomalies could be secondary to vascular involvement related directly or indirectly to the SARS-CoV2 virus. Full article
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11 pages, 270 KiB  
Article
Impact of COVID-19 on Eye Care in Spain during the First Phase of the Pandemic
by Carmen Antía Rodríguez-Fernández, María Varela-Agra, Lucía Pérez-Roldán, Ana Álvarez-Reguera, Cristina Martínez-Reglero and Ana Campo-Gesto
J. Clin. Med. 2021, 10(18), 4087; https://doi.org/10.3390/jcm10184087 - 10 Sep 2021
Cited by 4 | Viewed by 2047
Abstract
Background: The declaration of the first state of alarm for COVID-19 in March 2020 provoked changes in ophthalmological care. The objective of this study was to assess its impact on reorganising care activities, the mental health of ophthalmologists and the training of residents. [...] Read more.
Background: The declaration of the first state of alarm for COVID-19 in March 2020 provoked changes in ophthalmological care. The objective of this study was to assess its impact on reorganising care activities, the mental health of ophthalmologists and the training of residents. Methods: We sent an anonymous online questionnaire between August and October 2020 to consultant ophthalmologists and residents who were active during the state of alarm in Spain. We used Google Forms® software for data collection. We analysed responses according to the degree of regional impact. Results: We received a total of 328 responses from the 17 Autonomous Communities. We saw that 99.4% of respondents changed their work activities with 50% reductions in surgery (94.5%) and consultations (93.0%). Furthermore, 58.8% of respondents reported increased anxiety, and 29.9% transferred to support other services, with this number reaching 49.6% in the hardest-hit regions. Training programs were greatly reduced in external consultations (90.7%), and surgical training was completely cancelled (100%). Additionally, 56.5% of trainees wanted to prolong their residence periods. Conclusions: The first wave of the pandemic produced significant changes in ophthalmology services, and these changes were more pronounced in the most affected regions. It caused a negative psychological impact on a high rate of respondents and an interruption of the training of ophthalmology residents. Predictably, the negative consequences of this delay in ophthalmological care on patients will be uneven between regions. Full article
10 pages, 418 KiB  
Article
Impact on Visual Acuity in Neovascular Age Related Macular Degeneration (nAMD) in Europe Due to COVID-19 Pandemic Lockdown
by Carolina Arruabarrena, Mario Damiano Toro, Mehmet Onen, Boris E Malyugin, Robert Rejdak, Danielle Tognetto, Sandrine Zweifel, Rosa Giglio and Miguel A Teus
J. Clin. Med. 2021, 10(15), 3281; https://doi.org/10.3390/jcm10153281 - 25 Jul 2021
Cited by 34 | Viewed by 3142
Abstract
This is a retrospective, multicenter study of consecutive patients with nAMD scheduled for a visit and/or a treatment with an intravitreal injection (IVI) during the 3 months before lockdown in the Ophthalmology Departments of six centers of Europe.The study was conducted on 546 [...] Read more.
This is a retrospective, multicenter study of consecutive patients with nAMD scheduled for a visit and/or a treatment with an intravitreal injection (IVI) during the 3 months before lockdown in the Ophthalmology Departments of six centers of Europe.The study was conducted on 546 patients, of which 55.13% were females, almost 100% of the patients were White/Caucasian race, and 71.53% of the patients presented a type 1 macular neovascularization (NVM). A total of 62.82% of patients (343 patients) that were on scheduled clinic visits and/or intravitreal injection treatment during the 3 months before the quarantine did not attend either to visit or for treatment during the lockdown. The mean number of injections during the lockdown was significantly reduced. This was followed by a significant reduction in the mean best-corrected visual acuity (BCVA) between the 3 months before the lockdown (mean BCVA of 60.68 ± 19.77 letters) and 6 months after lockdown (mean BCVA of 56.98 ± 22.59 letters). Patients with better BCVA before the lockdown and the ones showing neovascular activity were more likely to attend their scheduled visits and/or IVI treatments. The COVID-19 pandemic and the lockdown have led to a decrease in the number of IVI treatments in patients with nAMD, evidencing a significant vision loss at 6 months. Full article
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