scholarly journals Ocular findings among patients surviving COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ílen Ferreira Costa ◽  
Livia Pimenta Bonifácio ◽  
Fernando Bellissimo-Rodrigues ◽  
Eduardo Melani Rocha ◽  
Rodrigo Jorge ◽  
...  

AbstractTo describe the medium-term ophthalmological findings in patients recovering from COVID-19. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. Socio-demographic data and personal medical history were also collected. According to the severity of systemic manifestations, patients were classified into mild-to-moderate, severe, and critical. Sixty-four patients (128 eyes) were evaluated 82 ± 36.4 days after the onset of COVID’s symptoms. The mean ± SD duration of hospitalization was 15.0 ± 10.7 days. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (0–0.2) and BCVA 0 (0–0.1). Anterior segment biomicroscopy was unremarkable, except for dry eye disease, verified in 10.9% of them. The mean ± SD intraocular pressure (IOP) in critical group (14.16 ± 1.88 mmHg) was significantly higher than in severe group (12.51 ± 2.40 mmHg), both in the right (p 0.02) and left eyes (p 0.038). Among all, 15.6% had diabetic retinopathy, and two patients presented with discrete white-yellowish dots in the posterior pole, leading to hyporreflective changes at retinal pigment epithelium level, outer segment, and ellipsoid layers. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. No sign of uveitis was found.

2021 ◽  
pp. 1-3
Author(s):  
Katja Göbel

To describe the medium-term ophthalmological findings in patients recovering from COVID-19. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. Socio-demographic data and personal medical history were also collected. According to the severity of systemic manifestations, patients were classified into mild-to-moderate, severe, and critical. Sixty-four patients (128 eyes) were evaluated 82 ± 36.4 days after the onset of COVID’s symptoms. The mean ± SD duration of hospitalization was 15.0 ± 10.7 days. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (0–0.2) and BCVA 0 (0–0.1). Anterior segment biomicroscopy was unremarkable, except for dry eye disease, verified in 10.9% of them. The mean ± SD intraocular pressure (IOP) in critical group (14.16 ± 1.88 mmHg) was significantly higher than in severe group (12.51 ± 2.40 mmHg), both in the right (p 0.02) and left eyes (p 0.038). Among all, 15.6% had diabetic retinopathy, and two patients presented with discrete white-yellowish dots in the posterior pole, leading to hyporreflective changes at retinal pigment epithelium level, outer segment, and ellipsoid layers. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. No sign of uveitis was found.


2021 ◽  
pp. 112067212199057
Author(s):  
Dario Pasquale Mucciolo ◽  
Myrta Lippera ◽  
Dario Giorgio ◽  
Andrea Sodi ◽  
Ilaria Passerini ◽  
...  

Purpose: To evaluate the correlation between Best Corrected Visual Acuity (BCVA) and the following parameters in Stargardt Disease (STGD): Central Retinal Thickness (CR-T), Central Outer Nuclear Layer Thickness (C-ONL-T), Areas of macular Photoreceptor loss (PHRa), and Retinal Pigment Epithelium (RPE) loss (RPEa). Methods: A total of 64 eyes of 32 STGD patients were included in the study. All patients received a comprehensive ophthalmological examination, color fundus photographs, fundus auto-fluorescence imaging, and Optical Coherence Tomography (OCT). The CR-T and C-ONL-T were evaluated from standard SD-OCT scans. The PHRa and RPEa were calculated from enface OCT scans (sub RPE slab and photoreceptor slab). The collected OCT parameters were evaluated for possible association with BCVA. Results: The mean macular PHRa and RPEa was 16.16 ± 13.36 and 12.05 ± 12.57 mm2 respectively. The mean CR-T measured 120.78 ± 41.49 μm while the mean C-ONL-T was assessed at 4.60 ± 13.73 μm. BCVA showed the highest correlation with the C-ONL-T ( r = −0.72; p < 0.001) while there was no correlation with the CR-T ( r = −0.17; p = 1.00). Conclusions: Enface OCT permits a rapid and precise quantitative evaluation of the macular PHR and RPE atrophy area in STGD. Nonetheless, the OCT parameter that showed the highest correlation with visual acuity in STGD was the ONL thickness.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Shakeel Ahmad ◽  
Rashida RIaz ◽  
Muhammad Haseeb ◽  
Hafiza Ammara Rasheed ◽  
Samia Iqbal

Purpose: To compare the mean difference of visual acuity as measured by auto refraction and subjective refraction. Study Design:  Descriptive cross-sectional study. Place and Duration of Study:  Department of ophthalmology, Services hospital Lahore from November 2013 to April 2014. Material and Methods:  Using non-probability consecutive sampling 300 eyes of 300 patients fulfilling inclusion criteria were recruited through OPD registration slip. Demographic data including age and gender was recorded. Complete ophthalmic examination was performed. This included measurement of refractive error by auto-refraction as well as subjective refraction. Detailed anterior segment examination with slit lamp and dilated fundus examination with indirect ophthalmoscopy was performed. The collected data was analyzed by using software SPSS version 17. Results:  The mean age of patients was 34.71 ± 7.45 years. There were 156 (52%) males and 144 (48%) females. There were 263 (87.69%) patients who had visual acuity of 6/6 and 37 (12.33%) had 6/9. Mean spherical auto-refraction and subjective refraction was 0.0290 ± 2.58 and -0.2842 ± 2.37 D with mean difference of -0.3133 ± 1.27 D. The mean cylindrical auto and subjective refraction in this study was -.9742 ± 0.78 D and -0.7500 ± 0.81 D and mean difference was 0.2242 ± 0.74 D. The mean cylindrical axis of auto and subjective refraction was 114.88 ± 49.75 and 115.60 ± 49.70 with mean difference as 0.72 ± 3.02 D (p-value < 0.05). Conclusion:  Difference of spherical, cylindrical and cylindrical axis in auto and subjective refraction was significantly different.


2021 ◽  
Author(s):  
damla bektaşoğlu ◽  
Semih Çakmak ◽  
Ahmet Kırgız ◽  
Nilay Kandemir Beşek ◽  
Burçin Kepez Yıldız ◽  
...  

Abstract Purpose: This study aimed to evaluate the anterior segment surgeries performed in the coronavirus (COVID-19) lockdown period when prevention is at the forefront, in terms of etiology, referral region, demographic characteristics, and surgeries performed.Methods: A total of 144 cases who underwent anterior segment surgeries between 19 March 2020 and1 June 2020 were retrospectively reviewed from archive files. The demographic data and ophthalmological examinations of the patients, the region they were referred from, and the surgeries performed were noted.Results: A total of 144 patients, 49 women (34%) and 95 men (66%), were included in this study. The mean age of the patients was 31.30±25.88 (1-86) years. The presenting complaint was in the right eye in 43.7% of the cases, in the left eye in 52.8%, and in both eyes in 3.5% of the cases. While 94.4% of all cases applied from Istanbul, the remaining 5.6% applied from outside the province. Whereas 43.7% of the cases consisted of patients we had followed up previously, 56.3% presented to our hospital for the first time. Our hospital was the first referenced center in only 39.6% of the cases. When evaluated in terms of etiology, corneal perforation (18.1%) was the most common, followed by keratitis (13.2%). The most common surgical intervention was amnion membrane transplantation (19.4%), followed by perforation repair (16.7%).Conclusion: Ophthalmologic surgeries are continuing during the ongoing COVID-19 intervention process. Special algorithms are required to reduce the risk of transmission in terms of COVID-19 and to ensure continuity of health care for ophthalmology patients.


2017 ◽  
Vol 27 (2) ◽  
pp. e32-e34 ◽  
Author(s):  
Andrea Mazzaferro ◽  
Adriano Carnevali ◽  
Ilaria Zucchiatti ◽  
Lea Querques ◽  
Francesco Bandello ◽  
...  

Purpose To evaluate the optical coherence tomography angiography (OCT-A) features of a peripapillary intrachoroidal cavitation (ICC) in a patient with high myopia. Methods A 67-year-old woman with ICC underwent visual acuity testing, refraction, slit-lamp biomicroscopy, dilated fundus examination, and OCT-A. The main findings are described in this case report. Results Best-corrected visual acuity was 20/20 in both eyes. Fundus examination revealed in the right eye a macular scar, a tilted disc along with a peripapillary staphyloma, and an orange-yellowish lesion on the inferior border of the disc. Structural OCT B-scan showed ICC as an intrachoroidal hyporeflective space located below the normal plane of the retinal pigment epithelium adjacent to the optic nerve head. Optical coherence tomography angiography showed the cavitation as a hyporeflective area, devoid of detectable flow from the choriocapillaris and large choroidal vessels layers, suggesting the choroid, including the residual hyperreflective tissue in the outer aspect of the retinal pigment epithelium/Bruch membrane, to be avascular in ICC. Conclusions Optical coherence tomography angiography demonstrated the absence of choroidal and choriocapillary network.


2020 ◽  
pp. 112067212092686
Author(s):  
Sebile Çomçalı ◽  
Pınar Topcu Yılmaz ◽  
Cemal Çavdarlı ◽  
Mehmet Numan Alp

Introduction Iodine deficiency is a leading cause of preventable physical and mental retardation. Potassium iodate is used for iodine supplementation to prevent iodine deficiency. We herein report a case of toxic retinopathy following intentional ingestion of potassium iodine. Case Presentation A 41-year-old male presented with a 5-day history of blurred vision in both eyes. His visual acuity (VA) was hand motion and his pupillary reactions were sluggish bilaterally. The fundus examination revealed bilaterally diffuse retinal pigment epithelium atrophy and secondary pigmentary changes at the posterior pole, but his peripheral fundus was relatively spared. Choroidal thinning, punctate hyperreflective dots along the retinal pigment epithelium layer, and outer retinal atrophy were the optical coherence tomography findings, which were consistent with widespread areas of retinal pigment epithelium window defects observed on fundus fluorescein angiography. The visual evoked potential test showed no response in the right eye and revealed a delay in the latency and a decrease in the amplitude of the P100 wave in the left eye. Wave b responses of the photoreceptors could not be observed in the patient’s electroretinogram. After a vitamin supplementation protocol consistent with the literature, at the 4-month follow-up visit his visual acuity had improved to 0.3 in the right eye and counting fingers in the left eye. Conclusion Potassium iodate toxicity is a cause of serious retinal and choroidal damage and results in severe vision loss. Hydration, hemodialysis, and antioxidants can be helpful to minimize the complications.


2021 ◽  
Author(s):  
Igor Oliveira da Fonseca ◽  
Stella de Angelis Trivellato ◽  
Mayara Apolinario Januzzi ◽  
Guilherme Drumond Jardini Anastacio ◽  
Igor de Lima e Teixeira

Background: The “Coca-Cola Bottle Sign” is a classic sign of thyroid diseases, especially Graves’ disease, with the appearance of eye orbit muscles edema seen by Magnetic Resonance Imaging. The belly of the muscle increases in thickness, giving the characteristic appearance. Despite being classically associated with this etiology, the finding may be present in other diseases, especially infiltrative ones. Objectives: To demonstrate how this radiological signal can suggest other etiologies, when atypical. Methods: Case report of a patient with an image finding suggestive of “CocaCola Bottle Sign”. Results: Patient, 71 years old, with Breast Cancer and Hepatic Metastasis, using Anastrazole. Osmophobia started and after 3 months, reduced visual acuity in the right eye, evolving in 20 days to amaurosis in the right eye, dizzying, and loss of visual acuity in the left eye. Upon examination, he had a missing direct pupillary reflex in the right eye and only light perception, and counting fingers in the left eye; paresis of the Superior Rectus, Medial, and Lower Oblique muscles of the Left Eye, with paresis maintained in the forced duction test. On ophthalmoscopy, he had atrophy of the retinal pigment epithelium in the bilateral periphery, without Papilledema. Metabolic screening did not show any relevant changes. In the Magnetic Resonance of Orbits, an intraconal nodular image was seen in the right orbital cavity, with perineuritis and extension to the belly of the lateral rectus muscle on this side, as the “Coca-Cola Bottle Sign”. Due to unilateral muscle involvement and signs of meningeal involvement, lumbar puncture with cytopathological examination was requested, being positive for Carcinoma Metastasis. Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, however, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation.


2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Mariana Sá-Cardoso ◽  
Arnaldo Dias-Santos ◽  
Natália Nogueira ◽  
Heloísa Nascimento ◽  
Rubens Belfort-Mattos

Purpose. To report a case of bilateral punctate inner choroidopathy (PIC).Case Report. A 26-year-old Caucasian woman presented with bilateral blurred vision with one year of evolution. There was no relevant systemic disease or family history. Best-corrected visual acuity in the right eye was 20/30 and in the left eye was 20/20; there was no clinically significant refractive error. Fundoscopy evidenced multiple, small, round, yellow-white lesions limited to the posterior pole of both eyes, with greater macular involvement in the RE. There were no signs of inflammation in the anterior chamber or vitreous cavity. Fluorescein angiography revealed the presence of multiple hyperfluorescent lesions more evident in the later stages of the angiogram in both eyes. On indocyanine green angiography, these lesions appeared hypofluorescent in both early and late phases. Optical coherence tomography showed the presence of focal elevations of the retinal pigment epithelium with underlying hyporeflective space, bilaterally. Laboratory and imaging evaluation for evidence of autoimmune and infectious diseases were negative.Conclusion. The PIC is a relatively uncommon condition. In this report, an attempt has been made to describe a classic clinic presentation of this disease in a young and female patient.


Doklady BGUIR ◽  
2020 ◽  
Vol 18 (8) ◽  
pp. 89-96
Author(s):  
Н. A. Sushchenia ◽  
L. N. Marchenko

Retinal detachment in children often requires multiple revisions. Despite active surgical treatment, subretinal fluid can persist for a long time in the macular region of the fundus. This leads to a decrease in visual acuity after surgery and an unsatisfactory functional result of treatment. In the absence of central vision, children develop amblyopia and secondary strabismus. Reoperations increase the risk of complications. Threshold laser coagulation leads to thermal burns of all layers of the retina with the formation of chorioretinal adhesion, which ensures adhesion of the retinal layers, but irreversibly damages the retinal neuroepithelium. Аs a result, the use of threshold laser coagulation in the macular zone is limited. The method of subthreshold micropulse diode laser ablation (STDLA) was developed on the basis of a clinical examination of 44 pediatric patients of the pediatric ophthalmology department of the Minsk Regional Children's Clinical Hospital, whose level of subretinal fluid in the posterior pole of the eyes remained for a long time after extrascleral surgery for retinal detachment. The proposed exposure parameters provide a selective effect on the cells of the retinal pigment epithelium with laser radiation in the micropulse mode without irreversible thermal denaturation of photoreceptors and without damage to the neuroepithelium in order to stimulate the resorption of subretinal fluid and correct transudative disorders. As a result, the adhesion of the retinal photoreceptor layer to the pigment epithelium is restored. The effectiveness of the method is confirmed by a decrease or complete disappearance of subretinal fluid, adhesion of neuroepithelium according to optical coherence tomography and leads to an increase in visual acuity. The proposed method made it possible to optimize the treatment of children with retinal detachment, to improve the anatomical and functional outcomes of treatment, which is of medical and socio-economic importance.


2020 ◽  
Vol 13 (9) ◽  
pp. e235882
Author(s):  
Nithin Teja Gunna ◽  
Deepika C Parameswarappa ◽  
Padmaja Kumari Rani

A 68-year-old man presented with diminution of distance and near vision in the right eye for a duration of 1 month postblunt trauma with a stick. On examination, his visual acuity in the right eye was 20/320 and near vision was <N36. Right eye fundus showed bullous neurosensory retinal detachment at posterior pole and retinal pigment epithelium (RPE) atrophic area temporal to fovea. Optical coherence tomography showed subretinal fluid with pigment epithelial detachment and an area of RPE and photoreceptor loss temporal to fovea. Fundus fluorescein angiography and indocyanine green angiography showed focal leaks and transmitted hyperfluorescence corresponding to the area of RPE loss. Left eye examination was unremarkable except for senile cataract of nuclear opalescence grade 3. A diagnosis of right eye bullous central serous chorioretinopathy (CSCR) and RPE sequelae postblunt trauma was made. Our patient was managed conservatively with no specific treatment for CSCR. One month later, there was improvement in vision with decrease in neurosensory detachment. The area of RPE loss remained the same with photoreceptor loss. Since this area of RPE and photoreceptor loss were temporal to fovea, our patient’s visual acuity was not affected significantly.


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