Purpose To evaluate the effect of COVID-19 on retinal tissues by conducting a systematic review and meta-analysis of the current literature. Background The novel coronavirus disease is not yet well understood. The orbit provides a window into the body's microvasculature, and as such, it is a non-invasive opportunity to analyse the systemic circulation in vivo. By analysing the current literature, we test the hypothesis that non-invasive imaging of the retina could provide insight into the effect of COVID-19 on the retinal microvasculature. Methods For this systematic review and meta-analysis, we screened PubMed databases and LitCOVID19 using the search criteria: (OCTA or Optical Coherence Tomography Angiography) AND (COVID-19 or corona or SARS-CoV-2) AND (retina or fundus). Databases were searched on 11 January 2022. The primary study outcomes were studies that utilised OCTA to analyse the retina; secondary outcomes involved studies that involved other imaging modalities such as OCT, fundus photography, and fundus autofluorescence. Findings The total number of studies included in this review was 32. Optical coherence tomography angiography scans show reduced central retinal vascular density, a thinner ganglion cell layer, a thicker retinal nerve fibre layer, and an enlarged foveal avascular zone. Optical coherence tomography scans demonstrate a thicker central macular thickness and other changes to the macula, ganglion cell, and inner nuclear layers. Many fundus photographs depicted cotton wool spots, microhaemorrhages, and vascular occlusions. Non-invasive imaging technology has demonstrated that COVID-19 can profoundly affect the retina. Therefore, there is a requirement for long-term follow-up of COVID-19 patients to assess whether the retinal damage caused by COVID-19 is reversible. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00509-8.
Mucopolysaccharidoses (MPS) are a rare group of lysosomal storage disorders characterized by the accumulation of incompletely degraded glycosaminoglycans (GAGs) in multiple organ systems including the eye. Visual loss occurs in MPS predominantly due to corneal clouding and retinopathy, but the sclera, trabecular meshwork and optic nerve may all be affected. Despite the success of therapies such as enzyme replacement therapy (ERT) and hematopoietic stem-cell transplantation (HSCT) in improving many of the systemic manifestations of MPS, their effect on corneal clouding is minimal. The only current definitive treatment for corneal clouding is corneal transplantation, usually in the form of a penetrating keratoplasty or a deep anterior lamellar keratoplasty. This article aims to provide an overview of corneal clouding, its current clinical and surgical management, and significant research progress.
Background: Uveitis in children and young people is a rare but potentially debilitating condition. Steroid eye drops are the first step in treatment and poor compliance may result in vision-threatening complications. This study aimed to measure compliance with prescribed eye drops prospectively and investigate reasons for non-compliance in a child-specific manner. Methods: 50 patients aged 0-18 years attending a tertiary paediatric uveitis clinic using steroid drops were recruited. Both the child or young person, and parent completed questionnaires about compliance. A subgroup had bottles of Prednisolone 1% drops weighed and dispensed at the first appointment and reweighed at follow-up. The reduction in weight was compared with expected weight change over the interval. Results: The study was completed by 31 patients. Drop errors for all eye drops were reported more than 'once a week' by 13 (33.3%) children and young people, and 3 (9.7%) parents. A large proportion of parents could not recall the frequency of drops prescribed to their child (13, 40.6%). Insufficient bottle weight reduction was found in 9 (75%), although this was not associated with self-reported drop errors. Within the eye drop weighing subgroup three (25%) used <50% the expected weight of drops. Conclusions: Eye drop compliance was demonstrated to be poor by all the study outcomes in children and young people with uveitis. Self-reported compliance is unreliable in this population, as subjective responses were not supported by objective bottle weight change. Worryingly, some patients miss more than 50% of drops and may suffer worse disease control.
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