Cargando…

Unfolding COVID-19: Lessons-in-Learning in Ophthalmology

IMPORTANCE: An observant Chinese doctor Li Wenliang became the first physician to alert the world about COVID-19. Being an ophthalmologist himself, he has put the additional onus on us. The fact that the ocular manifestation could be the first presenting feature of novel coronavirus pneumonia should...

Descripción completa

Detalles Bibliográficos
Autores principales: Kharel Sitaula, Ranju, Khatri, Anadi, Janani, M K, Mandage, Rajendra, Sadhu, Soumen, Madhavan, H N, Upadhyay, Madan Prasad, Biswas, Jyotirmay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532306/
https://www.ncbi.nlm.nih.gov/pubmed/33061265
http://dx.doi.org/10.2147/OPTH.S259857
_version_ 1783589897924247552
author Kharel Sitaula, Ranju
Khatri, Anadi
Janani, M K
Mandage, Rajendra
Sadhu, Soumen
Madhavan, H N
Upadhyay, Madan Prasad
Biswas, Jyotirmay
author_facet Kharel Sitaula, Ranju
Khatri, Anadi
Janani, M K
Mandage, Rajendra
Sadhu, Soumen
Madhavan, H N
Upadhyay, Madan Prasad
Biswas, Jyotirmay
author_sort Kharel Sitaula, Ranju
collection PubMed
description IMPORTANCE: An observant Chinese doctor Li Wenliang became the first physician to alert the world about COVID-19. Being an ophthalmologist himself, he has put the additional onus on us. The fact that the ocular manifestation could be the first presenting feature of novel coronavirus pneumonia should not be ignored and the possibility of spread of SARS-CoV-2 through the ocular secretions cannot be ruled out. However, with breakthroughs still evolving about this disease, the calls are now louder for closer examination on the pathogenesis of conjunctivitis associated with it. Hence, we conducted a scoping review of all available literature till date to fill in the “potential” gaps in currently available knowledge on ocular manifestations of SARS-CoV-2 infection in an attempt to establish continuity in the “chain of information” from December 2019 till April 2020. We also summarize a possible hypothesis on much less understood and highly debated topics on regard to the etiopathogenesis of ocular involvement in SARS-CoV-2 based on either presence or absence of ACE2 receptor in the ocular surface. METHODS: We conducted a scoping review search of published and unpublished SARS-CoV-2-related English language articles from December 2019 till mid of April 2020 from the online databases. The findings were summarized using text, tables, diagrams, and flowcharts. RESULTS: The commonest ocular manifestation in SARS-CoV-2 infection is follicular conjunctivitis and has been the first manifestation of SARS-CoV-2 infection in 3 reported cases till date. The ocular surface inoculated with the SARS-CoV-2 leads to the facilitation of the virus to the respiratory system via the lacrimal passage. RT-PCR analysis of the ocular secretions has shown the presence of the SARS-CoV-2 nucleotides indicating the possibility of infection of ocular secretions. ACE2 receptors and its expression on the ocular mucosal surface are linked behind the etiopathogenesis of conjunctivitis. CONCLUSION: Conjunctivitis can be the presenting manifestation but may go unnoticed due to its mild nature. The ocular surface could serve as the entry gateway for the virus and ocular secretions could play a role in virus shed. The eye care personnel, as well as the general people, need to be more vigilant and adopt protective eye measures.
format Online
Article
Text
id pubmed-7532306
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-75323062020-10-14 Unfolding COVID-19: Lessons-in-Learning in Ophthalmology Kharel Sitaula, Ranju Khatri, Anadi Janani, M K Mandage, Rajendra Sadhu, Soumen Madhavan, H N Upadhyay, Madan Prasad Biswas, Jyotirmay Clin Ophthalmol Review IMPORTANCE: An observant Chinese doctor Li Wenliang became the first physician to alert the world about COVID-19. Being an ophthalmologist himself, he has put the additional onus on us. The fact that the ocular manifestation could be the first presenting feature of novel coronavirus pneumonia should not be ignored and the possibility of spread of SARS-CoV-2 through the ocular secretions cannot be ruled out. However, with breakthroughs still evolving about this disease, the calls are now louder for closer examination on the pathogenesis of conjunctivitis associated with it. Hence, we conducted a scoping review of all available literature till date to fill in the “potential” gaps in currently available knowledge on ocular manifestations of SARS-CoV-2 infection in an attempt to establish continuity in the “chain of information” from December 2019 till April 2020. We also summarize a possible hypothesis on much less understood and highly debated topics on regard to the etiopathogenesis of ocular involvement in SARS-CoV-2 based on either presence or absence of ACE2 receptor in the ocular surface. METHODS: We conducted a scoping review search of published and unpublished SARS-CoV-2-related English language articles from December 2019 till mid of April 2020 from the online databases. The findings were summarized using text, tables, diagrams, and flowcharts. RESULTS: The commonest ocular manifestation in SARS-CoV-2 infection is follicular conjunctivitis and has been the first manifestation of SARS-CoV-2 infection in 3 reported cases till date. The ocular surface inoculated with the SARS-CoV-2 leads to the facilitation of the virus to the respiratory system via the lacrimal passage. RT-PCR analysis of the ocular secretions has shown the presence of the SARS-CoV-2 nucleotides indicating the possibility of infection of ocular secretions. ACE2 receptors and its expression on the ocular mucosal surface are linked behind the etiopathogenesis of conjunctivitis. CONCLUSION: Conjunctivitis can be the presenting manifestation but may go unnoticed due to its mild nature. The ocular surface could serve as the entry gateway for the virus and ocular secretions could play a role in virus shed. The eye care personnel, as well as the general people, need to be more vigilant and adopt protective eye measures. Dove 2020-09-28 /pmc/articles/PMC7532306/ /pubmed/33061265 http://dx.doi.org/10.2147/OPTH.S259857 Text en © 2020 Kharel Sitaula et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Kharel Sitaula, Ranju
Khatri, Anadi
Janani, M K
Mandage, Rajendra
Sadhu, Soumen
Madhavan, H N
Upadhyay, Madan Prasad
Biswas, Jyotirmay
Unfolding COVID-19: Lessons-in-Learning in Ophthalmology
title Unfolding COVID-19: Lessons-in-Learning in Ophthalmology
title_full Unfolding COVID-19: Lessons-in-Learning in Ophthalmology
title_fullStr Unfolding COVID-19: Lessons-in-Learning in Ophthalmology
title_full_unstemmed Unfolding COVID-19: Lessons-in-Learning in Ophthalmology
title_short Unfolding COVID-19: Lessons-in-Learning in Ophthalmology
title_sort unfolding covid-19: lessons-in-learning in ophthalmology
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532306/
https://www.ncbi.nlm.nih.gov/pubmed/33061265
http://dx.doi.org/10.2147/OPTH.S259857
work_keys_str_mv AT kharelsitaularanju unfoldingcovid19lessonsinlearninginophthalmology
AT khatrianadi unfoldingcovid19lessonsinlearninginophthalmology
AT jananimk unfoldingcovid19lessonsinlearninginophthalmology
AT mandagerajendra unfoldingcovid19lessonsinlearninginophthalmology
AT sadhusoumen unfoldingcovid19lessonsinlearninginophthalmology
AT madhavanhn unfoldingcovid19lessonsinlearninginophthalmology
AT upadhyaymadanprasad unfoldingcovid19lessonsinlearninginophthalmology
AT biswasjyotirmay unfoldingcovid19lessonsinlearninginophthalmology