People with severe COVID-19 may be at risk for serious eye problems, suggests a new study.
The study researchers analyzed information from 129 patients in France who were hospitalized with COVID-19 and subjected to brain scans with magnetic resonance imaging (Magnetic resonance imaging) Of these, nine patients, or 7%, showed signs of ocular abnormalities. Specifically, MRIs showed abnormalities called “nodules” on the back of their eyes, which may be signs of inflammation or direct damage to the eye, said the study’s author, Dr. Augustin Lecler, associate professor at the University of Paris, in an email.
All nine patients had nodules in the macula, which is responsible for central vision, that is, the ability to see clearly in front of them. Eight of the patients had “bilateral” nodules, which means they occurred in both eyes.
“The eye problems we encounter can potentially be very serious because they occur in the … macular region, which is the region responsible for giving us a clear view and the ability to see the details,” said Lecler, who is also a neuroradiologist at the Hospital Foundation Adolphe de Rothschild in Paris. “If it persists, it can lead to severe vision loss or even blindness.”
The results suggest that patients with severe COVID-19 may need to undergo eye exams, the authors wrote in their article published Tuesday (February 16) in the newspaper Radiology. They note that serious eye problems “can go unnoticed” among patients in the intensive care unit (ICU), as doctors focus on treating the life-threatening symptoms of the disease.
“It is essential to remember that eye problems can go unnoticed in the ICU, and doctors need to be vigilant to first identify whether there is an orbital [eye] problem to protect the patient’s vision, “wrote Dr. Claudia Kirsch, head of the neuroradiology division at Northwell Health School of Medicine Zucker Hofstra in Manhasset, New York, in a accompanying editorial in Radiology.
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COVID-19 has already been linked to eye symptoms, including conjunctivitis or pink eye, as well as damage to the retina of the eye, known as retinopathy. The new study is one of the first to report COVID-19-related eye abnormalities using MRI scans.
The exact cause of these nodules is unclear, but they can be signs of damage due to blocked blood vessels or bleeding in the eye, according to CNN.
It is also not known how the virus causes damage to the eyes. It is possible that SARS-CoV-2, the virus that causes COVID-19, could infect the eye directly, as retinal cells are known to express the ACE2 receptor, which allows the virus to enter cells, the authors said . The damage may also be due to the body’s inflammatory response to disease.
Nor can the authors rule out the possibility that the nodules are the result of a serious illness. In particular, they note that patients who spend time in the ICU in the “prone position”, that is, prone, or who are intubated with a breathing tube are at risk for eye abnormalities due to increased pressure in the eyes. Most patients in the current study with ocular abnormalities spent some time in a prone position in the ICU.
The study was limited because the researchers did not monitor patients to determine whether the abnormalities were temporary or whether they resulted in changes in vision. (The study was “retrospective” as doctors reviewed patient records after the fact and did not follow them over time.)
But the researchers are currently in the process of tracking these patients, and are studying additional patients with severe COVID-19 using MRIs, as well as comprehensive eye tests. They are also conducting similar studies in patients with mild cases of COVID-19, to see if these problems are specific to severe cases of the disease, said Lecler.
Originally published on Live Science.