Role of Eyes and Eyes Protection Amidst SARS-CoV-2 Infection

Thapa, Bibechan

doi:10.31729/jnma.5634

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…somatic cells. Angiotensin-converting enzyme 2 expression has been confirmed in SARS-CoV-2-transmissible sites including the conjunctiva, 6 which pathologically verifies that the virus is able to attach to the ocular surface. Yan et al 7 demonstrated that a patient with COVID-19 presenting with angle-closure glaucoma was immunopositive for ACE2 and SARS-CoV-2 nucleocapsid protein in the conjunctiva and trabecular meshwork tissue samples, respectively, that were surgically removed.…”

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confidence: 92%

COVID-19–Related Chronic Bilateral Dacryoadenitis

Kase

Ishida

2022

JAMA Ophthalmol

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he novel coronavirus disease (COVID-19), caused by SARS-CoV-2 infection, has been a serious global problem involving human health since 2019. SARS-CoV-2 is a positive-stranded RNA virus with an outer envelope surrounding the capsid constituted of the nucleocapsid protein.The envelope contains the spike glycoprotein (S), which is currently the major target of common messenger RNA (mRNA) vaccines against SARS-CoV-2. The critical routes by which SARS-CoV-2 gets into the human body are droplets and aerosol infection through the nasopharyngeal route as well as the conjunctival route. Ocular surface infections with SARS-CoV-2 are likely to allow the virus to transmit to nasopharyngeal epithelia through the lacrimal sac. 1 Therefore, pathological investigations regarding COVID-19 infection of the periocular tissues play crucial roles in better understanding how the virus spreads to the whole body. According to a 2020 review article, 2 the prevalence of ophthalmic manifestations in COVID-19 varied from 2% to 32% in different countries. Conjunctivitis is a relatively major ocular manifestation in patients with COVID-19; however, the frequency among patients is as low as other ophthalmic complications, such as retinal abnormalities, because the tear films might take part in the protection of conjunctival epithelia from virus attachments. 3 In addition, periocular COVID-19-related manifestations, including orbital cellulitis and dacryoadenitis, are extremely rare. 4,5 Angiotensin-converting enzyme 2 (ACE2) is a critical receptor by which SARS-CoV-2 preferentially adheres to the IMPORTANCE Pathological features of ophthalmic aftereffects of COVID-19 are important for new insight in treating patients.OBJECTIVE To examine the expression of SARS-CoV-2 nucleocapsid protein and angiotensin-converting enzyme 2 (ACE2) in lacrimal gland tissues of a patient with COVID-19 and a patient without COVID-19. DESIGN, SETTING, AND PARTICIPANTSIn this retrospective case-control study, the case of a 35-year-old woman with positive test results for SARS-CoV-2 who had had lacrimal gland enlargements for 6 months was analyzed. A 43-year-old woman without COVID-19 who had idiopathic chronic bilateral dacryoadenitis served as a negative control. MAIN OUTCOMES AND MEASURESHistopathology and immunohistochemistry with anti-SARS-CoV-2 nucleocapsid protein and ACE2 in the lacrimal glands.RESULTS Both patients were Japanese women aged 35 years (case) and 43 years (control). Histopathologic findings in the patient with COVID-19 demonstrated marked inflammatory cell infiltration, lymphoid follicles, and germinal center formation in the lacrimal gland. The inflammation was mainly made up of lymphocytes and plasma cells with several polymorphonuclear leukocytes, where the lacrimal glands were atrophic. Of note, a number of lacrimal gland ducts markedly contained eosinophilic materials in the lumens, which indicated glandular damage. Immunoreactivity for SARS-CoV-2 nucleocapsid protein was noted in the inflammatory cells around the lacrimal gland ductal epit...

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confidence: 92%

COVID-19–Related Chronic Bilateral Dacryoadenitis

Kase

Ishida

2022

JAMA Ophthalmol

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“…The second probable reason was a fast clearance rate of the virus from the ocular surface due to drainage via the nasolacrimal pathway, evaporation, and its low volume [ 7 , 25 ]. The third reason was the fact that ocular secretions were known to have a strong local immune system (lactoferrin and immunoglobulins) against coronavirus[ 7 , 24 , 25 ]. Lastly, the low number of ACE-2 receptors to have been shown in conjunctival tissue (< 50% lower than other tissues), thus their ability to bind to the virus is very poor [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…SARS-CoV-2 gains entry to host cells through angiotensin-converting enzyme 2 (ACE-2) receptors, which are expressed in many organs. Conjunctival and corneal cells were also shown to have ACE-2 receptors, thus providing possible route of entry [ 5 – 7 ]. Previous studies have found that the SARS-CoV-2 could be detected in tear and conjunctival tissues both in the presence and absence of ocular symptoms [ 1 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The ocular manifestations reported ranged from simple conjunctivitis with symptoms of red eyes, epiphora, conjunctival secretion, and chemosis to keratoconjunctivitis, posterior uveitis, retinitis, and optic neuritis, which affect visual acuity [4][5][6]10]. The prevalence of conjunctivitis in studies widely varied, ranging from 2 to 31% [7,11,12]. Another study also reported that 11.64% of COVID-19 cases experienced forms of ocular symptoms [6,13].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and clinical characteristic of ocular surface manifestation: an evaluation of conjunctival swab results in Corona Virus 2019 (COVID-19) patients in Jakarta, Indonesia

Susiyanti

Daniel

Faridah

et al. 2023

J Ophthal Inflamm Infect

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Objectives This study aimed to investigate the spectrum of ocular characteristics and viral presence in the conjunctival swab of patients with COVID-19. Methods In this cross-sectional study, fifty-three patients were recruited from two COVID-19 referral hospitals in Jakarta (Cipto Mangunkusumo Hospital and Persahabatan Hospital) from July 2020 to March 2021. The inclusion criteria were patients who were suspected of or confirmed cases of COVID-19 with or without ocular symptoms. Demographic data, history of COVID-19 exposure, underlying medical condition, systemic symptoms, ocular symptoms, supporting laboratory results, reverse-transcriptase polymerase chain reaction (RT-PCR) of naso-oropharyngeal (NOP) swab and conjunctival swab were collected. Results Fifty-three patients who were suspected, probable or confirmed cases of Covid-19 were included. Forty-six out of 53 patients (86.79%) tested positive for either Covid-19 antibody rapid test or naso-oropharyngeal (NOP) swab. Forty-two patients tested positive for NOP swab. Fourteen out of 42 patients (33.33%) experienced symptoms of ocular infection including red eye, epiphora, itchy eyes, and eye discharge. None of these patients were tested positive for conjunctival swab. Two out of 42 patients (4.76%), who were tested positive for conjunctival swab, did not experience any ocular symptoms. Conclusions Establishing the relationship between Covid-19 infection, ocular symptoms, and presence of SARS-CoV-2 virus on the ocular surface proves to be challenging. In Covid-19 patients, ocular symptoms did not warrant a positive conjunctival swab result. On the contrary, a patient without ocular symptoms can also have detectable presence of SARS-CoV-2 virus on the ocular surface.

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“…2 In addition, the eyes may serve as a source of infection and an entryway for transmission. 3 The clinical features of coronavirus disease 2019 (COVID-19) are variable, ranging from an asymptomatic state to acute respiratory distress syndrome and multiorgan dysfunction. 4 Since the pandemic was declared in March 2020, medical staff have expressed grave concerns regarding infection with the fast-spreading virus, and in particular, ophthalmologists due to the nature of their work and patient proximity during examinations.…”

Section: Introductionmentioning

confidence: 99%