Ophthalmology Commons^™

Bilateral Interstitial Keratitis Following Covid-19: A Case Report, Nathalie D. Daher, Zeba A. Syed

Wills Eye Hospital Papers

BACKGROUND: Although the primary target of severe acute respiratory syndrome coronavirus 2 is the respiratory tract, the expression of the angiotensin-converting enzyme 2 receptor in other tissues facilitates viral entry in others parts of the body, including ocular structures. Ocular manifestations may occur before, during, or after systemic infection.

CASE PRESENTATION: We report the case of a 60-year-old male who presented with bilateral interstitial keratitis after the onset of COVID-19, with ocular symptoms starting within 7 days after systemic symptoms. Laboratory investigation did not identify any alternative etiology for his disease, although the possibility of Epstein-Barr virus or herpes simpex …

Endogenous Mirna-Based Innate-Immunity Against Sars-Cov-2 Invasion Of The Brain, Walter J. Lukiw, Aileen I. Pogue

School of Medicine Faculty Publications

The severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, possesses an unusually large positive-sense, single-stranded viral RNA (ssvRNA) genome of about ~29,903 nucleotides (nt). In many respects, this ssvRNA resembles a very large, polycistronic messenger RNA (mRNA) possessing a 5′-methyl cap (m7GpppN), a 3′- and 5′-untranslated region (3′-UTR, 5′-UTR), and a poly-adenylated (poly-A+) tail. As such, the SARS-CoV-2 ssvRNA is susceptible to targeting by small non-coding RNA (sncRNA) and/or microRNA (miRNA), as well as neutralization and/or inhibition of its infectivity via the human body’s natural complement of about ~2650 miRNA species. Depending on host cell and tissue …

Frosted Branch Angiitis Presenting After A Sars-Cov-2 Infection., Akhila Alapati, Nathaniel Cameron, Sean Gratton, Erin Stahl, Mary Champion

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: To report a case of frosted branch angiitis presenting in a pediatric patient with unremarkable laboratory work-up apart from SARS-CoV-2 IgG antibodies.

OBSERVATIONS: Less than four weeks after a SARS-CoV-2 infection, a 10 year-old female presented to the emergency department with severe headache and intermittent fevers. During her hospital admission, the ophthalmology service was consulted for blurry vision. Subsequent eye examination revealed frosted branch angiitis. The patient initially received intravenous corticosteroids but was escalated to plasmapheresis to achieve resolution of her symptoms. Outpatient maintenance therapy consisted of an oral Prednisone taper and Infliximab infusion.

CONCLUSION AND IMPORTANCE: This case …

Wellness Study: Functional Visual Outcomes In Eye Disease Patients Following The Covid-19 Pandemic, Andrew Maher

Undergraduate Student Research Internships Conference

The COVID-19 pandemic has caused delays in health services and medical appointments, affecting approximately one in three Canadian adults. Elderly eye disease patients experienced delays in treatment for eye conditions including cataracts, glaucoma, and retinal diseases. The impact of these delays on functional visual outcomes and general health rating of elderly patients is not well understood. As part of the Wellness Study, we aimed to investigate the pandemic-related impacts on functional vision and general health rating in an elderly eye patient population in London, Ontario.

Does The Novel Coronavirus Use The Ocular Surface As An Entrance Into The Body Or As An Infection Site?, Remzi Karadag, Alp Kayiran, Christopher J Rapuano

Wills Eye Hospital Papers

This study attempts to review whether the coronavirus disease-2019 (COVID-19) is transmitted through the ocular surface and examine the symptoms and signs of ocular disease. Considering that COVID-19 is transmitted by airborne droplets and close contact with infected individuals, we will also review the conditions to which eye clinics and ophthalmologists should pay attention to prevent the transmission of the disease. Although some researchers have argued that COVID-19 transmission cannot occur through the ocular surface, most of them are of the opinion that the ocular surface is a potential pathway of transmission. Until date, ocular signs and symptoms have been …

Acute Macular Neuroretinopathy Associated With Covid-19 Infection, James A. David, George D. Fivgas

School of Medicine Faculty Publications

Purpose: To report a case of bilateral acute macular neuroretinopathy (AMN) associated with a COVID-19 infection. Observations: A 22-year-old female was referred for evaluation of bilateral scotomas concurrent with a mildly symptomatic COVID-19 infection. Exam showed normal visual acuity, bilateral reddish-brown petaloid retinal lesions which were hyporeflective on near infrared (NIR) optical coherence tomography (OCT), and had associated hypoperfusion of the deep vascular plexus on OCT-angiography (OCT-A) consistent with bilateral AMN. At follow-up, scotomas and retinal findings on near infrared imaging and spectral-domain optical coherence tomography had only slightly improved. Conclusions: COVID-19 has been documented to be the etiology of …

Covid-19 Vaccines And Thrombosis—Roadblock Or Dead-End Street?, Kenneth Lundstrom, Debmalya Barh, Bruce D. Uhal, Kazuo Takayama, Alaa A.A. Aljabali, Tarek Mohamed Abd El-Aziz, Amos Lal, Elrashdy M. Redwan, Parise Adadi, Gaurav Chauhan, Samendra P. Sherchan, Gajendra Kumar Azad, Nima Rezaei, Ángel Serrano-Aroca, Nicolas G. Bazan, Sk Sarif Hassan, Pritam Kumar Panda, Pabitra Pal Choudhury, Damiano Pizzol, Ramesh Kandimalla

School of Medicine Faculty Publications

Two adenovirus-based vaccines, ChAdOx1 nCoV-19 and Ad26.COV2.S, and two mRNA-based vaccines, BNT162b2 and mRNA.1273, have been approved by the European Medicines Agency (EMA), and are invaluable in preventing and reducing the incidence of coronavirus disease-2019 (COVID-19). Recent reports have pointed to thrombosis with associated thrombocytopenia as an adverse effect occurring at a low frequency in some individuals after vaccination. The causes of such events may be related to SARS-CoV-2 spike protein interactions with different C-type lectin receptors, heparan sulfate proteoglycans (HSPGs) and the CD147 receptor, or to different soluble splice variants of the spike protein, adenovirus vector interactions with the …

Microrna Heterogeneity, Innate-Immune Defense And The Efficacy Of Sars-Cov-2 Infection—A Commentary, Walter J. Lukiw

School of Medicine Faculty Publications

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a member of the genus Betacoronavirus in the family Coronaviridae, possesses an unusually large single-stranded viral RNA (ssvRNA) genome of about ~29,811 nucleotides (nt) that causes severe and acute respiratory distress and a highly lethal viral pneumonia known as COVID-19. COVID-19 also presents with multiple ancillary systemic diseases and often involves cardiovascular, inflammatory, and/or neurological complications. Pathological viral genomes consisting of ssvRNA, like cellular messenger RNA (mRNA), are susceptible to attack, destruction, neutralization, and/or modulation by naturally occurring small non-coding RNAs (sncRNAs) within the host cell, some of which are known as microRNAs (miRNAs). …

Acute-Onset Central Serous Retinopathy After Immunization With Covid-19 Mrna Vaccine, Nicholas Fowler, Noe R. Mendez Martinez, Bernardo Velazquez Pallares, Ramiro S. Maldonado

Ophthalmology and Visual Science Faculty Publications

Purpose
We report the case of a 33-year-old male who presented with unilateral central serous retinopathy three days after the injection of a COVID-19 vaccine.

Observations
A 33-year-old healthy Hispanic male referred to the ophthalmology service due to blurry vision and metamorphopsia in the right eye without any flashes, floaters, eye redness or pain. The patient reported that 69 hours prior to presentation he received the first dose of the Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine. He denied any past ocular history or pertinent medical history. He does not take any medicines and denies stressful factors in his life. The clinical …

Complication Rates In Resident Cataract Surgery After Elective Operating Room Shutdown During The Covid-19 Pandemic, Michael Schneider, Christian Mehregan Md, Collin Richards, Shibandri Das Md, Xihui Lin Md

Medical Student Research Symposium

Purpose: To assess the types of cataract surgeries being performed at one large eye institute from before and after the COVID-19 induced shutdown of elective surgeries in Spring 2020.

Methods: This is a retrospective chart review study of operative reports from resident performed cataract surgeries from January 1st, 2020 through July 31st, 2020. Cataract surgeries were categorized into Pre-COVID (Jan – Mar 2020) if they occurred prior to operating room (OR) shutdown on March 18th, 2020 and Post COVID for all cases which occurred after the shutdown orders were lifted (May – July 2020). A resident survey was also used …

Dry Eye: Patient Education, Mark Oet

Family Medicine Clerkship Student Projects

Recent literature has shown increased incidence of dry eye and eye strain symptomatology during the COVID-19 pandemic, coinciding with an increase in screen time for almost all populations. This project aims to address this observation at a community level by creating a patient-friendly education pamphlet for Newtown Primary Care about dry eye and digital ocular strain based on American Academy of Ophthalmology guidelines.

Covid Intensive Care Unit Through The Eyes Of Ophthalmologists, Laura Drayer Turner, Dharshana Ramanathan, Sneha Melmane, Geeta Menon

HCA Healthcare Journal of Medicine

The disproportionate impact of COVID on the mortality and morbidity of people of black, Asian and minority ethnic (BAME) backgrounds has been recognised and is under investigation. Here we present a different impact: that on the psyche. As three doctors of BAME heritage, we shared an experience of being redeployed from ophthalmology to the COVID Intensive Care Unit. We share our reflections on the experience and lessons learned.