&lt;p&gt;Anterior Acute Uveitis Report in a SARS-CoV-2 Patient Managed with Adjunctive Topical Antiseptic Prophylaxis Preventing 2019-nCoV Spread Through the Ocular Surface Route&lt;/p&gt;

Mazzotta, Cosimo; Giancipoli, Ermete

doi:10.2147/imcrj.s260252

Cited by 39 publications

(37 citation statements)

References 26 publications

(85 reference statements)

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“…Our scienti c understanding of thefactors involved in SARS-CoV-2 viral transmission and a nity for multiple human host cell targets continues to evolve. There isnow an expanding list of documented impairmentsof the human visual systemand multiple types of visual dysfunction and/or vision de ciency associated with COVID-19 infection [15][16][17][18][19][20][21][22][23][24][25]46,[51][52][53][60][61][62][63]. The current study provides new insight into the distribution of the ACE2 receptor in eye and brain cells and tissues involved in visual signal processing.The ACE2 receptor is acknowledged as the major molecular receptor for SARS-CoV-2, and speci c anatomical regions of the eye and the visual circuitry of the brain contain abundantly detectable ACE2 receptor mRNA and protein.…”

Section: Discussionmentioning

confidence: 99%

Angiotensin Converting Enzyme 2 (ACE2) Expression in the Visual System

Hill

Clément

Arceneaux

et al. 2021

Preprint

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Background: Multiple lines of evidence currently indicate that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)gains entry into human host cells via a high-affinity interaction with the angiotensin-converting enzyme 2 (ACE2) transmembrane receptor. Research has further shown the widespread expression of the ACE2 receptor on the surface of many different immune, non-immune and neural host cell types, and that SARS-CoV-2 has there markable capability to attack many different types of human-host cells simultaneously. One principal neuroanatomical region for highACE2 expression patterns occurs in the brainstem, an area of the brain containing regulatory centers for respiration, and this may in part explain the predisposition of many COVID-19 patients to respiratory distress. Early studies also indicated extensive ACE2 expression in the whole eye and the brain’s visual circuitry. In this study we analyzed ACE2 receptor expression at the mRNA and protein level in multiple cell types involved in human vision, including cell types of the external eye and several deep brain regions known to be involved in the processing of visual signals.Methods: ACE2 mRNA and protein analysis; multiple eye and brain cells and tissues; gamma32P-adenosine tri-phosphate ([γ-32P]dATP) radiolabeled probes; Northern analysis; ELISA.Results: The four main findings were: (i)that many different optical and neural cell types of the human visual system provide receptors essential for SARS-CoV-2 invasion; (ii)the remarkable ubiquity of ACE2 presence in cells of the eye and anatomical regions of the brain involved in visual signal processing; (iii)that ACE2 receptor expression in different ocular cell types and visual processing centers of the brain provide multiple compartments for SARS-CoV-2 infiltration; and (iv)a gradient of increasing ACE2 expression from the anterior surface of the eye to the visual signal processing areas of the occipital lobe and the primary visual neocortex.Conclusion: A gradient of ACE2 expression from the eye surface to the occipital lobe provide the SARS-CoV-2 virus a novel pathway from the outer eye into deeper anatomical regions of the brain involved in vision. These findings may explain, in part, the many recently reported neuro-ophthalmic manifestations of SARS-CoV-2infection in COVID-19 affected patients.

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Section: Discussionmentioning

confidence: 99%

Angiotensin Converting Enzyme 2 (ACE2) Expression in the Visual System

Hill

Clément

Arceneaux

et al. 2021

Preprint

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“…Einige wenige Fälle sind bekannt, bei denen Patienten mit COVID-19 eine intraokuläre Entzündung aufwiesen [50,51]. Eine COVID-19-Patientin zeigte neben einer bilateralen follikulären Konjunktivitis erstmalig unilateral eine milde Uveitis anterior [51]. Diese wurde mit Steroiden, Antibiotika, Antiseptika und Mydriatika behandelt und heilte ohne Residuen innerhalb von 4 Wochen aus [51].…”

Section: Intraokuläre Manifestationenunclassified

“…Eine COVID-19-Patientin zeigte neben einer bilateralen follikulären Konjunktivitis erstmalig unilateral eine milde Uveitis anterior [51]. Diese wurde mit Steroiden, Antibiotika, Antiseptika und Mydriatika behandelt und heilte ohne Residuen innerhalb von 4 Wochen aus [51]. Eine weitere COVID-19-Patientin zeigte eine unilaterale Panuveitis mit Papillitis [50].…”

Section: Intraokuläre Manifestationenunclassified

Ocular Involvement in COVID-19: Conjunctivitis and More

Rokohl

Grajewski

Matos

et al. 2021

Klin Monbl Augenheilkd

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Since the beginning of 2020, SARS-CoV-2, the pathogen of COVID-19, has led to a global pandemic that also affects ophthalmology. Ophthalmologists can be confronted at any time with potentially COVID-19 associated ocular symptoms or manifestations in patients and also become infected through close patient contact. Even without systemic infection, the ocular surface can come into direct contact with aerosols or liquids containing SARS-CoV-2 particles. A smear infection through hand-to-eye contact is also possible. A purely isolated ocular infection has not yet been shown. Rather, it seems that ocular complications occur in the context of a systemic infection. However, ocular symptoms can also be the first symptom of COVID-19. The most common ocular complication of COVID-19 is mild follicular conjunctivitis. Haemorrhagic conjunctivitis, dry eye disease, episcleritis, or retinal involvement can also occur less frequently. There are currently no evidence-based therapy recommendations for COVID-19 associated diseases of the ocular surface. Artificial tears might be helpful for symptom relief. There is no evidence for antiviral, antibiotic, or anti-inflammatory therapies, but these medications might be used in individual cases. Potential intraocular complications include retinal artery occlusions and haemorrhages, as well as cotton wool spots caused by complement-mediated thrombotic angiopathy. Neuro-ophthalmological complications including Miller-Fisher syndrome or infarct-related central blindness can also occur in very rare cases. Knowledge of potential transmission routes and personal protective equipment is just as essential for each ophthalmologist as a basic knowledge of potential ocular symptoms and complications.

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“…The first case of COVID-19 related acute anterior uveitis associated with acute follicular conjunctivitis and conjunctival hyperemia was reported in Italy. Acute anterior uveitis was characterized by bilateral eye redness lasting two weeks, unilateral photophobia, lacrimation, miosis, aqueous humour flare and anterior lens opacity causing blurred vision [16].…”

Section: Sars-cov-2 Related Ocular Manifestations 41 Ocular Surface Manifestationsmentioning

confidence: 99%

“…Ocular surfaces are possible viral entry and infection sites, or gateway for spread of the virus to the respiratory system [8,9]. Although ocular symptoms are rare in COVID-19 patients, manifestations affecting the ocular surfaces such as conjunctivitis, epiphora, chemosis [10,11], retinal hemorrhages, central retinal vein occlusion (CRVO), ischemia [12][13][14][15] as well as blurred vision and vision loss [16,17] have been reported.…”

Section: Introductionmentioning

confidence: 99%

Potency of SARS-CoV-2 on Ocular Tissues

Durak¹,

Sutova²,

Yetisgin³

et al. 2021

Infectious Eye Diseases - Recent Advances in Diagnosis and Treatment

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The current COVID-19 pandemic has affected more than 100 million people and resulted in morbidity and mortality around the world. Even though the disease caused by SARS-CoV-2 is characterized by respiratory tract involvement, previous and recent data also indicates ocular manifestation. Not surprisingly, cell entry point of the virus, ACE2 receptor, is widely expressed in ocular tissues ranging from conjunctiva to retina. Despite the sensibility of ocular tissues, the sophisticated defense mechanism of the eye might eliminate viral transmission. Nevertheless, the potential of systemic transmission through the nasolacrimal duct may not be eliminated. In the case of ocular involvement, the disease outcomes might be as treatable as conjunctivitis or as serious as retinal degeneration and the treatment regimen vary accordingly. Within these contingencies, our aim with this chapter is to shed light on molecular bases of SARS-CoV-2 infection, systemic invasiveness following ocular transmission, manifestation and permanent effects on ocular tissues.

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<p>Anterior Acute Uveitis Report in a SARS-CoV-2 Patient Managed with Adjunctive Topical Antiseptic Prophylaxis Preventing 2019-nCoV Spread Through the Ocular Surface Route</p>

Cited by 39 publications

References 26 publications

Angiotensin Converting Enzyme 2 (ACE2) Expression in the Visual System

Angiotensin Converting Enzyme 2 (ACE2) Expression in the Visual System

Ocular Involvement in COVID-19: Conjunctivitis and More

Potency of SARS-CoV-2 on Ocular Tissues

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