Doctors are warning that covid-19 may be able to cause persistent eye problems. A new study suggests that some people who survive a serious infection may develop growths in the back of their eyes that can lead to loss of vision. It is not yet clear how covid-19 can cause these growths, or if people with milder covid-19 are also at risk of this complication.
Researchers from the French Society of Neuroradiology analyzed medical records of certain patients with severe covid-19. All of these patients had had an MRI scan of the brain at some point during the disease, which allowed researchers to look for potential abnormalities in and around the eye.
In total, they analyzed data from 129 patients in 16 hospitals that were infected during the first wave of the pandemic in France, between March and May 2020. Nine of these patients (7%) had evidence of nodules around the back of the eyeball, with the majority having tumors in both eyes. Eight patients were also in the intensive care unit.
There have been occasional reports of people with covid-19 with abnormal test results or health problems related to the eye, such as conjunctivitis (pink eye). But the authors say this is the first study to attempt to estimate how often this may be happening using MRI data. The findings should be enough to convince doctors to look for potential eye problems in patients with serious illnesses, they add, especially since they can be difficult to detect at first.
“Serious eye problems can go unnoticed, as these patients are often treated in intensive care units for much more serious and potentially fatal conditions,” they wrote in their article, Published Tuesday in the journal Radiologia. “Our data support the need for screening and monitoring of these patients to provide adequate treatment and improve the management of potentially serious ophthalmic manifestations.”
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The results have their limitations. They cannot conclusively demonstrate that having covid-19 led to these eye growths, nor can they explain how it could have happened if the disease was responsible. A theory expressed by the authors is that the infection reached the eyes and directly damaged the retina. Another is that inflammation caused indirectly by the infection is the main culprit. Thisit is even possible that the practice of placing patients face down (face down) –a common intervention that has been shown to help patients breathe easier– could have contributed to defective drainage of the veins connected to the eye. Pre-existing circulation problems, common in patients with diabetes, can also be a factor.
The researchers are already working on future studies to better understand these potential complications. This includes the proactive study of severe covid-19 patients from more recent pandemic waves, which would be confirm if these growths and other eye problems are actually the result of the disease and not a previous period, hidden issue. Survivors of these growths are also being screened to see if they are at increased risk for too longvision problems. And the researchers are conducting a similar study, focusing on patients with mild to moderate covid-19.
“We launched a prospective study with dedicated high-resolution MRI images to explore the eye and orbit in patients with mild to moderate COVID,” said lead author Augustin Lecler, radiologist and associate professor at the University of Paris, in a demonstration launched by the Radiological Society of North America, which publishes Radiology. “Therefore, we will be able to know whether our findings were specific to patients with severe COVID or not.”