Ocular Manifestations of COVID-19 (SARS-CoV-2): A Critical Review of Current Literature

Douglas, Konstantinos A A; Douglas, Vivian Paraskevi; Moschos, Marilita M

doi:10.21873/invivo.11952

Cited by 70 publications

(75 citation statements)

References 76 publications

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“…There are many antiviral treatments currently used against SARS-CoV-2 infection for which ocular side effects (mainly related to conditions other that direct cellular toxicity, such as inflammatory responses, autoimmunity reactivation, and vascular damage) have been pointed out [ 22 ]. Unlike these antivirals, ritonavir appears to exert a toxic effect on the outer retina and RPE, causing their irreversible degeneration in the long term and threatening the central vision without therapeutic options available.…”

Section: Resultsmentioning

confidence: 99%

Possible Retinal Impairment Secondary to Ritonavir Use in SARS-CoV-2 Patients: A Narrative Systematic Review

Cozzupoli

Savastano

Falsini

et al. 2020

Journal of Ophthalmology

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Some reports described a possible ritonavir-related retinal toxicity. The objective of this research was to review and analyze previous studies conducted on ritonavir administration and retinal impairment in a narrative synthesis. PubMed was used to perform a systematic review of ritonavir effects and retinal damage. All studies up to December 2019 were considered. Seven single cases and one case series, reporting a total of 10 patients affected by retinal changes secondary to long-term ritonavir treatment, were included in the review. Variable degrees of outer retina and retinal pigment epithelium changes were detected in most of the patients, with two patients showing macular telangiectasia, four patients presenting intraretinal crystal deposits, two patients disclosing a bull’s eye maculopathy, and two patients revealing midperipheral bone spicule-like pigment changes. In the present study, we hypothesized that the use of ritonavir in life-saving treatments of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pneumonia might expose these patients to the risk of developing a retinotoxicity. We aimed to alert ophthalmologists on the importance of recognizing ritonavir-induced retinal impairment in SARS-CoV-2 patients. These findings are the target for personalized medicine.

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Section: Resultsmentioning

confidence: 99%

Possible Retinal Impairment Secondary to Ritonavir Use in SARS-CoV-2 Patients: A Narrative Systematic Review

Cozzupoli

Savastano

Falsini

et al. 2020

Journal of Ophthalmology

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“…They found a correlation between ocular symptoms and higher levels of white blood cells, especially in neutrophils, as well as higher levels of procalcitonin, C-reactive protein, and lactate dehydrogenase. These acute phase reactants were also correlated to ocular manifestations in different articles [1,6,9,17].…”

Section: Ocular Manifestationsmentioning

confidence: 93%

“…To this day, health systems worldwide are still struggling to control this disease. The pathogen was identified as an enveloped RNA betacoronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1,2]. SARS-CoV-2 is the seventh member of the coronavirus family that is able to infect humans.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and the eye: a review

Domínguez-Varela

Rodríguez-Gutiérrez

Morales-Mancillas

et al. 2021

Infectious Diseases

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Background: To provide a review for general practitioners and medical specialists about the most common eye complaints and ocular manifestations in a COVID-19 patient. Methods: Reviewed 50 articles referenced in 4 databases from 20 December 2019 to 16 September 2020. Results: Of the 50 articles reviewed, 26 met the criteria for analysis and were included in the study. Among them were 5 reviews, 6 case series, 7 case reports, 4 cross-sectional studies, 2 systematic reviews, 1 cohort study and 1 correspondence. We found that the prevalence of ocular manifestations in patients during the course of COVID-19 varied between 0.8% and 31.6%, depending on the study design. Symptoms of acute conjunctivitis were the most frequent clinical findings. Acute phase reactants were also correlated to ocular manifestations and the severity of the systemic disease in many reports. Conclusions: Ocular manifestations are not uncommon in COVID-19 patients and have been associated with higher levels of acute phase reactants as well as a higher degree of severity of the systemic disease. We recommend that all physicians consider COVID-19 as a differential diagnosis in the presence of acute conjunctivitis with or without systemic symptoms.

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“…Several studies have been published that detail the early missteps of several countries, including the United States, regarding testing and infection control measures. [26][27][28][29][30][31] We know that failure to implement early lockdown, lack of testing, and inadequate medical equipment crippled our first response to COVID-19. Extensive testing, contact tracing, social distancing, and adequate personal protective equipment are necessary to prevent further transmission and prevent overwhelming our health systems.…”

Section: Immediate Actionsmentioning

confidence: 99%

<p>Preserving Vision in the COVID-19 Pandemic: Focus on Health Equity</p>

Mike¹,

Laroche²

2020

OPTH

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The coronavirus 19 (COVID-19) pandemic has overwhelmed our healthcare systems and caused the deaths of tens of thousands of Americans. Black and Hispanic individuals comprise a disproportionate number of those deaths, primarily because of preexisting health conditions such as hypertension, obesity, and asthma. Health inequities that underlie these disparities also exist within ophthalmology around the world, and more ophthalmologists should advocate for healthcare reform that advances health equity. Immediate actions to reduce health disparities in ophthalmology during the pandemic include taking time to ensure all ophthalmology leadership and industry is diversified with people reflecting the fabric of their countries, embracing telemedicine to increase access to medical care, and advocating for legislation that will increase health insurance coverage during this unprecedented time. Longitudinal actions include recognizing structural racism as a root cause of health inequity and actively rejecting it through addressing modifiable risk factors, increasing cultural competency training, promoting diversity in the workforce, and global leadership.

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Ocular Manifestations of COVID-19 (SARS-CoV-2): A Critical Review of Current Literature

Cited by 70 publications

References 76 publications

Possible Retinal Impairment Secondary to Ritonavir Use in SARS-CoV-2 Patients: A Narrative Systematic Review

Possible Retinal Impairment Secondary to Ritonavir Use in SARS-CoV-2 Patients: A Narrative Systematic Review

COVID-19 and the eye: a review

<p>Preserving Vision in the COVID-19 Pandemic: Focus on Health Equity</p>

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