Objective Multisystem inflammatory syndrome (MIS-C) in children is associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and can be mortal with the involvement of multiple organ systems. However, long-term effects on all organs and organ systems involvement are still unclear or even whether this condition may still occur in which organs. This report aims to identify ocular findings in children with MIS-C on the follow-up. Methods This is a prospective cross-sectional study. Cases diagnosed with MIS-C between May 2020 and February 2021 in our hospital (e.g., cases aged 1 month–18 years old) were included in the study. The same ophthalmologist followed up with the patients after discharge. Patients underwent detailed ophthalmic examinations, including slit lamp biomicroscopy and fundoscopy, best-corrected visual acuity, and Schirmer's 2 test. Results Our study included 22 patients treated with the MIS-C. Twelve (54.5%) were girls, and 10 (45.5%) were boys. Their mean age was 8.7 ± 4.9 years. Pathological ocular findings were found in six (27.2%) patients in the follow-up. The most common finding was punctate epitheliopathy in four (18.2%) patients. The cause of punctate epitheliopathy was dry eye. All patients recovered with treatment. Conclusion Our study is the first to evaluate ocular findings in MIS-C in the long term. Regardless of the severity of the disease, the most common ocular finding in our study was punctate epitheliopathy, that is, dry eye. According to our results, we think patients should be followed up on pathological ocular findings after discharge.
BACKGROUND/OBJECTIVES: The most frequently reported ocular finding in the acute phase of the multisystem inflammatory syndrome in children (MIS-C), is conjunctivitis. More rarely, punctuate epitheliopathy, anterior uveitis and optic disc oedema can be seen. We aimed to investigate the acute and long-term ocular effects of MIS-C. SUBJECTS/METHODS: Cases aged 1 month to 18 years who were diagnosed with MIS-C between January 2022 and June 2022 in the Department of Pediatric Infectious Diseases in our hospital were included in the study. Ophthalmological examinations were performed immediately after diagnosis, at one month, three months, and six months. RESULTS: Males consisted of 64.7% of the 34 cases included in the study and the mean age was 8.68 ± 4.32 years (min-max:2-17). In the first examination, conjunctivitis was observed in 6 (17.6%), punctuate epitheliopathy in 4 (11.7%), and subconjunctival haemorrhage in 3 (8.8%) patients. Two patients (5.8%) had optic disc oedema. No pathological anterior or posterior segment findings were observed in the sixth-month examination. The relationship between subconjunctival haemorrhage and intensive care hospitalisation was statistically significant (p = 0.014). Also, all patients with subconjunctival haemorrhage were clinically classified as severe MIS-C (p = 0.002). CONCLUSION: Although pathological ocular findings were observed in the acute phase of the disease, all of them were found to be improved at the sixth-month follow-up. The most striking finding of our study is that cases with subconjunctival haemorrhage were clinically more severe, and all patients needed intensive care. This study may be informative in establishing ocular follow-up protocols that are expected to be carried out in the acute period and in the follow-up of these patients.
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