Unveiling endophthalmitis post COVID-19 – A case series

Khatwani, Paras R; Goel, Nikita; Trivedi, Kinjal; Aggarwal, Somesh

doi:10.4103/ijo.ijo_1616_21

Cited by 11 publications

(7 citation statements)

References 5 publications

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“…The administration of steroids for treatment of COVID-19 was also reported to result in central serous chorioretinopathy 84 . In a series of 7 COVID-19 cases complicated by endogenous endophthalmitis, 6 cases were secondary to mucormycosis-associated sinusitis or systemic fungal infections, and all had received intravenous corticosteroid for COVID-19 85 . As prolonged use of systemic steroids creates an immunocompromised state and predisposes patients to such sight-threatening complications, ophthalmologists ought to have a high index of suspicion in their evaluation of these patients.…”

Section: Resultsmentioning

confidence: 99%

“…84 In a series of 7 COVID-19 cases complicated by endogenous endophthalmitis, 6 cases were secondary to mucormycosis-associated sinusitis or systemic fungal infections, and all had received intravenous corticosteroid for COVID-19. 85 As 112 Bilateral transient visual field defect prolonged use of systemic steroids creates an immunocompromised state and predisposes patients to such sight-threatening complications, ophthalmologists ought to have a high index of suspicion in their evaluation of these patients. The use of HCQ and CQ during the early COVID-19 period sparked heated debates within and beyond the ophthalmology community.…”

Section: Ocular Side Effects Arising From Treatment and Preventionmentioning

confidence: 99%

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COVID-19: Update on Its Ocular Involvements, and Complications From Its Treatments and Vaccinations

Lin

Zheng

et al. 2021

Asia-Pacific Journal of Ophthalmology

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The coronavirus disease 2019 (COVID-19) came under the attention of the international medical community when China first notified the World Health Organization of a pneumonia outbreak of then-unknown etiology in Wuhan in December 2019. Since then, COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has appalled the world by spreading at a pandemic speed. Although ophthalmologists do not directly engage in the clinical care of COVID-19 patients, the ophthalmology community has become aware of the close ties between its practice and the pandemic. Not only are ophthalmologists at heightened risk of SARS-CoV-2 exposure due to their physical proximity with patients in routine ophthalmic examinations, but SARS-CoV-2 possesses ocular tropism resulting in ocular complications beyond the respiratory tract after viral exposure. Furthermore, patients could potentially suffer from adverse ocular effects in the therapeutic process. This review summarized the latest literature to cover the ophthalmic manifestations, effects of treatments, and vaccinations on the eye to aid the frontline clinicians in providing effective ophthalmic care to COVID-19 patients as the pandemic continues to evolve.

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Section: Resultsmentioning

confidence: 99%

Section: Ocular Side Effects Arising From Treatment and Preventionmentioning

confidence: 99%

COVID-19: Update on Its Ocular Involvements, and Complications From Its Treatments and Vaccinations

Lin

Zheng

et al. 2021

Asia-Pacific Journal of Ophthalmology

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“…Неправильное использование кортикостероидов для лечения ранних легких симптомов COVID-19 у пациентов с диабетом и с ослабленным иммунитетом может еще больше увеличить риск развития тяжелого течения COVID-19 и смертность. Пациенты с диабетом и COVID-19, получающие кортикостероиды, нуждаются в более тщательном наблюдении в отношении инвазии грибковой инфекции [36,37].…”

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Features of the Course and Rare Ophthalmic Manifestations of Post-COVID Syndrome

et al. 2023

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The review presents data from studies of the ophthalmological consequences of the disease caused by SARS-CoV-2, especially regarding its rare manifestations. Clinical manifestations of the post-COVID-19 syndrome disappear within about two weeks in mild cases and 3 to 12 weeks in more severe cases. 80 % of patients have more than one, often more than two, and more than 10 symptoms. In general, patients improve spontaneously and continuously over time. The ophthalmic manifestations of COVID-19 vary in nature, severity, and timing, and are more common in patients with severe systemic disease, abnormal blood counts, and inflammatory conditions. Ophthalmic manifestations can develop at any time during the course of the disease. The median time to symptom onset since COVID-19 diagnosis is 5 days for neuro-ophthalmic manifestations, 8.5 days for the ocular surface and anterior segment of the eye, and 12 days for the posterior segment and orbit. COVID-19 causes ocular manifestations in approximately 11 % of patients. The most common ocular manifestation is conjunctivitis, which affects almost 89 % of patients with eye diseases. Other much less common anterior segment anomalies caused by SARS-CoV-2 include scleritis, episcleritis, and acute anterior uveitis. Posterior segment injuries caused by SARS-CoV-2 are mainly vascular, such as hemorrhages, cotton wool spots, dilated veins, and vasculitis. Rare complications of COVID-19 include rhino-orbital-cerebral mucormycosis; retrobulbar optic neuropathy, papillitis, neuroretinitis, anterior ischemic optic neuropathy, non-arterial anterior ischemic optic neuropathy; retinal white spot syndrome (MEWDS); acute unilateral anterior uveitis, serpiginous choroiditis; bilateral central serous chorioretinopathy; bilateral acute depigmentation of the iris, bilateral acute transillumination of the iris; refraction changes; complications associated with drugs used to treat COVID-19 that have toxic effects on eye tissue; and vaccine-associated uveitis.

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“…Of note is that all the reported cases of endophthalmitis in COVID-19-infected individuals share a common ground of prolonged hospital admission (>2 weeks) and the use of systemic steroids for more than 10 days. [ 4 5 6 ] Though both bacteria and fungi have been reported to cause post-COVID-19 endophthalmitis, fungal isolates such as candida, aspergillus, and mucormycosis have been more commonly reported. The resurgence of fungal endogenous endophthalmitis in the COVID-19 era can be well attributed to the extended use of steroids and broad-spectrum antibiotics along with the constitutional immunosuppression and neutrophil dysfunction levied by the COVID-19 virus.…”

mentioning

confidence: 99%

“…A recent series on endogenous endophthalmitis in COVID-19 patients requiring hospitalization showed rapid progression of the endophthalmitis with loss of functional vision over 7 days after the onset of symptoms. [ 6 ] Due to availability and logistics-related challenges, it might not always be possible for all admitted patients to undergo a dilated fundus examination, However, a simple test of bedside visual acuity evaluation during admission and at the time of discharge can assist in the early identification of visual symptoms wherein timely intervention can provide an opportunity to salvage vision.…”

mentioning

confidence: 99%