Central retinal artery occlusion with cilioretinal artery sparing secondary to COVID-19: Additional ocular complication

Oliveira, Marcela Rv de; Lucena, Ana Regina Vp; Higino, Taciana Mm; Ventura, Camila V.

doi:10.4103/ijo.ijo_1246_22

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…It should be noted that both veins and arteries can experience thromboembolic complications in COVID-19 [33], which is illustrated by the following case of central retinal artery embolism in a patient with COVID-19 with elevated levels of D-dimer, C-reactive protein, and fibrinogen [51]. A group of authors describe cases of central retinal artery embolism in the above-mentioned infectious disease, while laboratory tests showed elevated levels of ferritin, D-dimer, procalcitonin, interleukin-6, C-reactive protein, and fibrinogen [13,18].…”

Section: Discussionmentioning

confidence: 99%

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

Hutsaliuk,

Skalska,

Ulianova

2024

CSO

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Aims: To study the relationship between the severity of COVID-induced metabolic changes and the structure and frequency of retinal chan- ges, according to funduscopy data in patients with different clinical courses of COVID-19. Materials and methods: 117 patients with COVID-19 were examined. While examining patients, severity of the course of COVID-19, the expressiveness of changes in the metabolic status were determined; fundus image registration was performed with portable fundus cameras Pictor Plus Fundus Camera and VistaView (Volk Optical). Results: As a result of the research, retinal changes were found in 49 (41.9 %) patients with COVID-19. In 8 (16.3 %) cases, clinically significant (vitreous hemorrhage, prethrombosis of the central retinal vein or branches of the central retinal vein, thrombosis of the central retinal vein or branches of the central retinal vein) COVID-induced retinal and ophthalmological changes were observed, which caused a decrease in visual acuity. In 41 (83.7 %) cases, clinically insignificant changes (cotton wool spots, narrowed retinal vessels, intraretinal and petechial hemorrhages, tortuosity and dilatation of retinal venules) COVID-induced retinal changes were observed. Clinically significant retinal chan- ges occur in patients with a statistically significantly higher level of D-dimer and a greater percentage of lung parenchyma lesion than in the group of patients with clinically insignificant retinal changes (p < 0.05). Conclusions: The structure of retinal changes in patients with COVID-19 correlates with the severity of the clinical course of the disease and changes in the metabolic status of patients. Metabolic changes are correlated with retinal changes and can be predictive for preventing general vascular complications in COVID-19.

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Section: Discussionmentioning

confidence: 99%

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

Hutsaliuk,

Skalska,

Ulianova

2024

CSO

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“… 60 , 61 It may also affect the posterior pole in an isolated manner and is related to the mechanism of ischemia of the deep capillary plexuses supplied exclusively by the ciliary system. 62 , 63 …”

Section: Ophthalmological Symptoms In the Course Of Covid-19mentioning

confidence: 99%

The Review of Ophthalmic Symptoms in COVID-19

Stawowski,

Konopińska,

Stawowski

et al. 2024

OPTH

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The COVID-19 pandemic caused by SARS-CoV-2 had a significant impact on the health of the global human population, affecting almost every human organ, including the organ of vision. Research focus on understanding the pathophysiology, identifying symptoms and complications of the disease. Eye-related pathologies are important foci of research due to the potential for direct impact of the virus. Ophthalmologists around the world are reporting various symptoms of eye infections and ocular pathologies associated with SARS-CoV-2. The review of ophthalmic symptoms was conducted to help physicians of various specialties recognize possible ophthalmic manifestations of this viral disease. A literature review was conducted from January 2020 to July 2023 in the PubMed, MEDLINE, Science Direct, Scopus, Scielo and Google Scholar databases. The review of the literature showed that conjunctivitis is the most common ophthalmic symptom observed during the course of COVID-19 and can occur at any stage of the disease. Changes in the eye may result from the direct effect of the virus, immune response, prothrombotic states, comorbidities, and medications used. Symptoms related to the organ of vision can be divided into: changes affecting the protective apparatus of the eye, the anterior eye segment, the posterior eye segment, neuro-ophthalmic, and orbital changes. Ocular symptoms may suggest COVID-19 infection or appear several weeks after recovery. Following COVID-19 vaccinations, a diverse range of ophthalmic symptoms was observed in various locations and at different times, mirroring the ocular symptoms experienced throughout the course of the COVID-19 illness. It is important for physicians of all specialties to be aware of possible potential connections between eye diseases and SARS-CoV-2, in order to effectively diagnose and treat patients.

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“…In addition to causing severe acute respiratory syndrome, COVID-19 has shown persistent ocular complications in human patients [2][3][4][5]. SARS-CoV-2 has demonstrated ocular tissue tropism with pervasive ocular manifestations, including conjunctivitis, keratoconjunctivitis, episcleritis, hyperemia, chemosis, epiphora, dry eye or foreign body sensation, eye redness, tearing, itching, ocular pain, cotton wool spots, hyperreflective lesions at the level of ganglion cell and inner plexiform layers, retinal artery and vein occlusion, retinal hemorrhage, vascular sheathing, macular neuroretinopathy, optic nerve infarction, optic nerve edema, optic neuropathies, cerebral vein thrombosis, uveitis, and glaucoma [2,[6][7][8][9][10][11][12][13][14][15]. Recently, we reviewed the ocular complications caused by many conventional and emerging viruses, including SARS-CoV-2, which is considered relatively uncommon due to underreporting or improper diagnosis [16].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 infects cells lining the blood-retinal barrier and induces a hyperinflammatory immune response in the retina via systemic exposure

Monu,

Ahmad,

Olson

et al. 2024

PLoS Pathog

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SARS-CoV-2 has been shown to cause wide-ranging ocular abnormalities and vision impairment in COVID-19 patients. However, there is limited understanding of SARS-CoV-2 in ocular transmission, tropism, and associated pathologies. The presence of viral RNA in corneal/conjunctival tissue and tears, along with the evidence of viral entry receptors on the ocular surface, has led to speculation that the eye may serve as a potential route of SARS-CoV-2 transmission. Here, we investigated the interaction of SARS-CoV-2 with cells lining the blood-retinal barrier (BRB) and the role of the eye in its transmission and tropism. The results from our study suggest that SARS-CoV-2 ocular exposure does not cause lung infection and moribund illness in K18-hACE2 mice despite the extended presence of viral remnants in various ocular tissues. In contrast, intranasal exposure not only resulted in SARS-CoV-2 spike (S) protein in different ocular tissues but also induces a hyperinflammatory immune response in the retina. Additionally, the long-term exposure to viral S-protein caused microaneurysm, retinal pigmented epithelium (RPE) mottling, retinal atrophy, and vein occlusion in mouse eyes. Notably, cells lining the BRB, the outer barrier, RPE, and the inner barrier, retinal vascular endothelium, were highly permissive to SARS-CoV-2 replication. Unexpectedly, primary human corneal epithelial cells were comparatively resistant to SARS-CoV-2 infection. The cells lining the BRB showed induced expression of viral entry receptors and increased susceptibility towards SARS-CoV-2-induced cell death. Furthermore, hyperglycemic conditions enhanced the viral entry receptor expression, infectivity, and susceptibility of SARS-CoV-2-induced cell death in the BRB cells, confirming the reported heightened pathological manifestations in comorbid populations. Collectively, our study provides the first evidence of SARS-CoV-2 ocular tropism via cells lining the BRB and that the virus can infect the retina via systemic permeation and induce retinal inflammation.

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Central retinal artery occlusion with cilioretinal artery sparing secondary to COVID-19: Additional ocular complication

Cited by 4 publications

References 10 publications

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

The Review of Ophthalmic Symptoms in COVID-19

SARS-CoV-2 infects cells lining the blood-retinal barrier and induces a hyperinflammatory immune response in the retina via systemic exposure

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