PURPOSETo evaluate ocular manifestations and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) prevalence in the tears of children with coronavirus disease 2019 . METHODSA total of 27 pediatric patients with confirmed COVID-19 infection hospitalized from March 16 to April 15, 2020, at the Bambino Ges u Children's Hospital were enrolled in the study. At admission, all patients showed ocular manifestations. Reverse transcriptase-polymerase chain reaction from nasopharyngeal and conjunctival swabs were performed every 2-3 days before discharge. RESULTSOf the 27 patients, 4 (15%) were asymptomatic, 15 (56%) showed respiratory symptoms, and 8 (30%) had gastrointestinal symptoms. At admission, nasopharyngeal swabs were positive for COVID-19 in all patients; on the second swabs, 7 children (26%) tested negative, and 20 remained positive for COVID-19. Ocular manifestations consistent with mild viral conjunctivitis were observed in 4 patients (15%). At first conjunctival swab, 3 patients (11%), 1 symptomatic and 2 asymptomatic for ocular infection, had positive findings for COVID-19; 2 became negative on the second test and 1 on the third. CONCLUSIONSIn our study cohort, ocular manifestations of COVID-19 seem to have had a milder clinical course in pediatric patients than in adults. Despite the low prevalence and rapid regression of viral presence in the conjunctiva, SARS-CoV-2 transmission through tears may be possible, even in patients without apparent ocular involvement. ( J AAPOS 2020;24: 212-215) S ince its onset in December 2019 in Wuhan (Hubei Province, China) the coronavirus disease 2019 (COVID-19) has quickly spread across the globe, causing a global pandemic, according to the World Health Organization (WHO). 1 The pathogen of COVID-19 is a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can cause multiple system infections but mainly respiratory tract infections, such as severe acute respiratory syndrome. 2,3 The most common signs and symptoms include fever, cough, fatigue, myalgia, dyspnea, diarrhea. 4,5 Compared with adults, children with COVID-19 seem to have lower incidence, shorter course of disease, and a more favorable clinical presentation and prognosis. 6,7 The transmission route of this novel coronavirus (SARS-CoV-2) remains unclear, and most authors report that it occurs mainly through direct contact or respiratory droplets. 4 Previous studies have investigated the viral presence in tears of patients with SARS-CoV-1 and SARS-CoV-2, reporting controversial results. [8][9][10][11][12][13][14] All of these studies were performed in adult patients. In this study we evaluated ocular involvement and the SARS-CoV-2 virus shedding in tears of 27 pediatric patients admitted to the Bambino Ges u Children's Hospital (BGCH) COVID Center in order to better understand the pathogenicity of SARS-CoV-2 in children's eyes. Subjects and MethodsThis study was approved by the Bambino Ges u Children's Hospital Ethics Committee and adhered to the tenets of the Declaratio...

Results of this preliminary study suggest that an oral treatment with AOs in PRD subjects may have a protective effect on retinal cells, as detected by ERG analysis, through the strengthening of the plasma AO barrier.

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Paediatric optic pathway gliomas are low-grade brain tumours characterized by slow progression and invalidating visual loss. Presently there is no strategy to prevent visual loss in this kind of tumour. This study evaluated the effects of nerve growth factor administration in protecting visual function in patients with optic pathway glioma-related visual impairment. A prospective randomized double-blind phase II clinical trial was conducted in 18 optic pathway glioma patients, aged from 2 to 23 years, with stable disease and severe visual loss. Ten patients were randomly assigned to receive a single 10-day course of 0.5 mg murine nerve growth factor as eye drops, while eight patients received placebo. All patients were evaluated before and after treatment, testing visual acuity, visual field, visual-evoked potentials, optic coherence tomography, electroretinographic photopic negative response, and magnetic resonance imaging. Post-treatment evaluations were repeated at 15, 30, 90, and 180 days Brain magnetic resonance imaging was performed at baseline and at 180 days. Treatment with nerve growth factor led to statistically significant improvements in objective electrophysiological parameters (electroretinographic photopic negative response amplitude at 180 days and visual-evoked potentials at 30 days), which were not observed in placebo-treated patients. Furthermore, in patients in whom visual fields could still be measured, visual field worsening was only observed in placebo-treated cases, while three of four nerve growth factor-treated subjects showed significant visual field enlargement. This corresponded to improved visually guided behaviour, as reported by the patients and/or the caregivers. There was no evidence of side effects related to nerve growth factor treatment. Nerve growth factor eye drop administration appears a safe, easy and effective strategy for the treatment of visual loss associated with optic pathway gliomas.