Severe Bilateral Vision Loss in 2 Patients With Coronavirus Disease 2019

Cyr, Daniel G.; Vicidomini, C.; Siu, Nga Yan; Elmann, Solly E

doi:10.1097/wno.0000000000001039

Cited by 30 publications

(54 citation statements)

References 7 publications

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“…ON is a manifestation of acute demyelinating disease involving the optic nerve and has been previously associated with viral infections and other autoimmune diseases [ 18 ]. Feline and murine models of the disease have reported ON as a possible manifestation of COVID-19 [ 19 ]. Recently, there have been isolated reports of ON pathology in confirmed SARS-CoV-2-infected adults [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Neurological manifestations temporally associated with SARS-CoV-2 infection in pediatric patients in Mexico

et al. 2021

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Purpose To describe the temporal association of specific acute neurological symptoms in pediatric patients with confirmed SARS-CoV-2 infection between May and August 2020. Methods We performed a recollection of all the clinical and laboratory data of patients having acute neurological symptoms temporally associated with SARS-CoV-2 infection at a third-level referral hospital in Mexico City (Instituto Nacional de Pediatría). Patients in an age group of 0–17 years with acute neurological signs (including ascending weakness with areflexia, diminished visual acuity, encephalopathy, ataxia, stroke, or weakness with plasma creatinine kinase (CK) elevation) were evaluated. Results Out of 23 patients with neurological manifestations, 10 (43%) had a confirmed SARS-CoV-2 infection. Among the infected patients, 5 (50%) were males aged 2–16 years old (median age 11.8 years old). Four (40%) patients confirmed a close contact with a relative positive for SARS-CoV-2, while 6 (60%) cases had a history of SARS-CoV-2–related symptoms over the previous 2 weeks. The following diagnoses were established: 3 cases of GBS, 2 of ON, 2 of AIS, one of myositis with rhabdomyolysis, one ACA, and one of anti-NMDA-R encephalitis. Conclusions Neurological manifestations temporally associated with SARS-CoV-2 infection were noticed in the pediatric population even without respiratory symptoms. In this study, 2 of 6 symptomatic patients had mild respiratory symptoms and 4 had unspecific symptoms. During this pandemic, SARS-CoV-2 infection should be considered as etiology in patients with acute neurological symptoms, with or without previous respiratory manifestations, particularly in teenagers.

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Section: Discussionmentioning

confidence: 99%

Neurological manifestations temporally associated with SARS-CoV-2 infection in pediatric patients in Mexico

et al. 2021

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“…Acute onset of bilateral, painless vision loss should prompt the treating physicians to advise an urgent imaging of the brain with angiography. [ 67 ] Yang et al described the development of bilateral supranuclear gaze palsy with right branch retinal artery occlusion in a 60-year old patient with a history of atrial fibrillation, COPD, bladder carcinoma on chemotherapy and bacterial endocarditis. Diffusion-weighted MRI revealed an infarct in left paramedian midbrain.…”

Section: Neuro-ophthalmic Manifestations Of Covid-19mentioning

confidence: 99%

“…Acute onset of bilateral, painless vision loss should prompt the treating physicians to advise an urgent imaging of the brain with angiography. [ 67 ]…”

Section: Neuro-ophthalmic Manifestations Of Covid-19mentioning

confidence: 99%

COVID-19 and Eye

Sen

Honavar

Sharma

et al. 2021

Indian Journal of Ophthalmology

256

141

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The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had health implications of unprecedented magnitude. The infection can range from asymptomatic, mild to life threatening respiratory distress. It can affect almost every organ of the body. Ophthalmologists world over are reporting various manifestations of the infection in the eye. This review was undertaken to help ophthalmologists recognize the possible manifestations and the stage of the viral disease when they commonly appear. Literature search was performed for the publications on ophthalmic manifestations of coronavirus disease-19 (COVID-19) between January 1, 2020 and January 31, 2021. 46 case reports, 8 case series, 11 cross sectional/cohort observational studies, 5 prospective interventional studies, 3 animal models/autopsy studies and 6 reviews/meta-analysis were included. Conjunctivitis is the most common manifestation and can develop at any stage of the disease. Direct effect due to virus, immune mediated tissue damage, activation of the coagulation cascade and prothrombotic state induced by the viral infection, the associated comorbidities and drugs used in the management are responsible for the findings in the eye. The viral ribonucleic acid (RNA) has been isolated from ocular tissues but the role of eye as a route for infection is yet to be substantiated. Ophthalmic manifestations may be the presenting feature of COVID-19 infection or they may develop several weeks after recovery. Ophthalmologists should be aware of the possible associations of ocular diseases with SARS-CoV-2 in order to ask relevant history, look for specific signs, advise appropriate tests and thereby mitigate the spread of infection as well as diagnose and initiate early treatment for life and vision threatening complications.

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“…The severe COVID-19 patients hospitalized in an intensive care unit (ICU) setting may be attributed to secondary fungus endophthalmitis [ 18 ]. Case reports with acute macular neuroretinopathy [ 28 , 29 ], optic nerve infarction [ 30 ], and cerebral venous thrombosis [ 31 , 32 ] have been reported as well. Thus, the inflammatory-associated responses secondary to COVID-19 should be paid careful attention.…”

Section: Ocular Signs Of Covid-19 Patientsmentioning

confidence: 99%

The Transmission of SARS-CoV-2 Infection on the Ocular Surface and Prevention Strategies

Kitazawa

Deinhardt‐Emmer

Inomata

et al. 2021

Cells

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health problem. Although the respiratory system is the main impaired organ, conjunctivitis is one of its common findings. However, it is not yet understood if SARS-CoV-2 can infect the eye and if the ocular surface can be a potential route of SARS-CoV-2 transmissions. Our review focuses on the viral entry mechanisms to give a better understanding of the interaction between SARS-CoV-2 and the eye. We highlighted findings that give evidence for multiple potential receptors of SARS-CoV-2 on the ocular surface. Additionally, we focused on data concerning the detection of viral RNA and its spike protein in the various ocular tissues from patients. However, the expression level seemed to be relatively low compared to the respiratory tissues as a result of a unique environment surrounding the ocular surface and the innate immune response of SARS-CoV-2. Nevertheless, our review suggests the ocular surface as a potential route for SARS-CoV-2 transmission, and as a result of this study we strongly recommend the protection of the eyes for ophthalmologists and patients at risk.

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Severe Bilateral Vision Loss in 2 Patients With Coronavirus Disease 2019

Cited by 30 publications

References 7 publications

Neurological manifestations temporally associated with SARS-CoV-2 infection in pediatric patients in Mexico

Neurological manifestations temporally associated with SARS-CoV-2 infection in pediatric patients in Mexico

COVID-19 and Eye

The Transmission of SARS-CoV-2 Infection on the Ocular Surface and Prevention Strategies

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