Comparison of Ocular Findings in Patients with H1N1 Influenza Infection versus Patients Receiving Influenza Vaccine during a Pandemic

Abstract

Aim: To evaluate ocular findings during the pandemic influenza A (H1N1) and after vaccination for the same strain. Patients and Methods: This study was conducted on 89 patients with H1N1 influenza infection (group 1) and 28 subjects who received vaccination for H1N1 (group 2). All patients were subjected to history taking, ophthalmological examination, fundus examination, conjunctival impression cytology and conjunctival swabs. Results: The patients’ age ranged between 5 and 60 years (19.25 ± 11.70 years). Group 1included 43 (48.1%) males and 46 (51.9%) females, while group 2 included 13 (46.43%) males and 15 (53.57%) females. The most common ocular finding of patients in group 1 was bilateral acute conjunctivitis in 58 cases (65.17%), while in group 2, we found 3 (10.71%) cases of mild conjunctivitis, and 2 (7.14%) cases of moderate conjunctivitis. Retinopathy, uveal affection, and optic neuritis were not statistically different between the 2 groups. Impression cytology of the conjunctiva for group 1 showed squamous metaplasia grade 3 with enlargement of epithelial cells, and fragmentation of the nucleus which is similar to virus-infected structural changes. Conclusion: Pandemic influenza H1N1 was able to induce different ocular manifestations including acute conjunctivitis, retinopathy, uveal effusion syndrome and optic neuritis.

Oseltamivir inhibits influenza virus replication and transmission following ocular-only aerosol inoculation of ferrets

“…Furthermore, viruses not typically associated with an ocular tropism, such as the 2009 H1N1 pandemic virus, have nonetheless been found capable to cause ocular symptoms in infected individuals (Mansour et al, 2012). Thus, our finding that oseltamivir treatment following ocular exposure reduces virus transmission to naïve contacts when a respiratory infection is established supports the use of antiviral treatments in outbreak settings where ocular symptoms such as conjunctivitis are the primary manifestation of disease.…”

The eyes have it: influenza virus infection beyond the respiratory tract

“…32,38 Most of these reports describe previously healthy individuals; further data are needed to determine whether immunocompromised individuals are more susceptible to non-respiratory influenza virus exposure or are more likely to present with ocular complications following influenza virus infection. In the absence of antiviral treatments that specifically target ocular disease caused by RNA viruses, 7 influenza-positive patients presenting with conjunctivitis or other ocular complications are typically treated with oseltamivir (table 1).…”

Epidemiology, ecology and gene pool of influenza A virus in Egypt: Will Egypt be the epicentre of the next influenza pandemic?

“…151 In addition to the flu-like illness induced by the virus, 152 ocular manifestations were also reported. 153 Zoonotic transmission of IAV in Egypt Hitherto, 3 IAV sub-types have successfully jumped from animals to humans in Egypt; H1N1, H5N1 and H10N7 ( Table 1).…”