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COVID-19 associated with potentially dangerous eye abnormalities

A 56-year-old man with severe COVID-19. Diagnosis of SARS-CoV-2 infection was based on a positive quantitative real-time RT-PCR test of SARS-CoV-2 nucleic acid performed in the nasopharynx and lower respiratory tract swabs. The patient was hospitalized in the intensive care unit for 20 days when MRI was performed due to delayed arousal despite discontinuation of sedation. He presented with acute respiratory distress syndrome and had a median Simplified Acute Physiology Score (SAPS II) of 45. He was intubated with a high flow of oxygen and placed in the prone position. A, B, 3D FLAIR-weighted MRIs have been reformatted on the axial plane to show some hyperintensity nodules of the Earth’s posterior poles in the macula (white arrowhead) and extramacular region (black arrowhead). Note the presence of localized temporal retinal detachment in the left eye (arrow).Credit: Radiological Society of North America

Researchers using MRI have found significant abnormalities in the eyes of some people with severe COVID-19, according to a study published in the journal. Radiology.. The findings support the need for eye screening in these patients to provide adequate treatment and management of potentially severe eye symptoms of COVID-19.

The COVID-19 pandemic has affected more than 100 million people since it began in early 2020. The virus primarily attacks the lungs, but is associated with eye abnormalities such as conjunctivitis and retinopathy, also known as pink eyes. The retina that can cause vision loss. MRI scans have reported visible eye abnormalities, but studies on the nature and frequency of these abnormalities are limited.

To find out more, the French Academy of Neuroradiology (SFNR) has begun a study of 129 patients with severe COVID-19 who underwent brain MRI.

Of the 129 patients, 9 (7%) had abnormal MRI findings of the earth or eye. MRI scans showed one or more nodules in the posterior or posterior pole of the eye. Eight of the nine patients spent in the COVID-19 intensive care unit (ICU).

“We have shown that some patients with severe COVID-19 from the French COVID-19 cohort have one or more nodules at the posterior pole of the Earth,” said Augustin Lecler, lead author of the study. MD, Ph.D. Said the associate professor. A neuroradiologist in the Department of Neuroradiology at the University of Paris and the Foundation Adolf De Rothschild Hospital in Paris. “This is the first time these findings have been explained using MRI.”

All nine patients had nodules in the macula area. The macula area is the area behind the eyes that is responsible for our central vision. Eight had nodules in both eyes.

The results suggest that screening should be considered in all patients with severe COVID-19 to detect these nodules. In clinical practice, the screening may include a dedicated eye search with high-resolution MRI, the researchers said. Other recommended tests include fundus examination, which uses a magnifying lens and a light to check the back of the inside of the eye, and optical coherence tomography, which is a non-invasive examination that provides a 3D image of the structure of the eye.

COVID-19 associated with potentially dangerous eye abnormalities

A 56-year-old man with severe COVID-19. Diagnosis of SARS-CoV-2 infection was based on a positive quantitative real-time RT-PCR test of SARS-CoV-2 nucleic acid performed in the nasopharynx and lower respiratory tract swabs. The patient was hospitalized in the intensive care unit for 20 days when MRI was performed due to delayed arousal despite discontinuation of sedation. He presented with acute respiratory distress syndrome and had a median Simplified Acute Physiology Score (SAPS II) of 45. He was intubated with a high flow of oxygen and placed in the prone position. A, B, 3D FLAIR-weighted MRIs have been reformatted on the axial plane to show some hyperintensity nodules of the Earth’s posterior poles in the macula (white arrowhead) and extramacular region (black arrowhead). Note the presence of localized temporal retinal detachment in the left eye (arrow).Credit: Radiological Society of North America

Dr. Lecler said that severe eye problems can be largely overlooked in the clinic, as COVID-19 patients admitted to the ICU are often treated for much more serious and life-threatening conditions. I said there is.

“Our study suggests screening all patients admitted to the ICU for severe COVID-19,” said Dr. Lecler. “We believe these patients should receive specific eye protection treatments.”

The mechanism behind nodule formation is unknown, researchers said, but it may be related to inflammation caused by the virus. Inadequate drainage of the veins of the eye, which is a problem seen in patients in the ICU in the prone or intubated position, may also be a factor. Seven of the nine patients with eye abnormalities in this study were placed in the prone position for an extended period of time in the ICU.

Researchers perform follow-up laboratory tests and MRI scans of survivors to monitor the nodules and see if there are any clinical effects such as loss of vision or visual field impairment.

They are also new patients with severe COVID-19 from the second and third waves of the pandemic, performing MRI examinations using a more comprehensive ophthalmic examination to correlate with MRI results.

The effects of moderate COVID-19 on patients are currently under investigation.

“We have begun a prospective study using dedicated high-resolution MR images to explore the eyes and orbits of patients with mild to moderate COVID,” said Dr. Lecler. “Therefore, we can see if our findings were specific to severely ill COVID patients.”

The findings support previous studies showing that COVID-19 imposes greater sacrifices on people with existing health problems. Of the nine patients with nodules, two had diabetes, six were obese, and two had hypertension.


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For more information:
“MRI findings of the eye in patients with severe COVID-19: retrospective multicenter observational study” Radiology, 2021.

Provided by the Radiological Society of North America

Quote: COVID-19 (2021, February 16) associated with potentially dangerous eye abnormalities is https: //medicalxpress.com/news/2021-02-covid-linked-potentially-dangerous-eye.html Obtained from February 16, 2021

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COVID-19 associated with potentially dangerous eye abnormalities

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