International Journal of Ophthalmology Press -->新冠肺炎与眼科

A review of research of conjunctiva transmission and conjunctivitis of SARS-CoV-2

Jing Liu and Jun Feng — 2020/8/19 19:18:43

Corona virus disease 2019(COVID-19)epidemic caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has broken out with a vengeance, seriously threatening the global public health security. Due to the lack of specific effective drugs, effective and positive protective measures are still the most effective ways to prevent COVID-19. Clinical studies had shown that patients with COVID-19 might develop conjunctivitis symptoms. An animal experiment had also confirmed that the conjunctiva was one of the routes of SARS-CoV-2 transmission. However, current studies have gotten different or even contrary conclusions, and the relationship between SARS-CoV-2 infection and the occurrence of conjunctivitis has not been elucidated. Therefore, this article combines the latest clinical and animal studies to further elaborate the relationship between SARS-CoV-2 conjunctivatransmission and conjunctivitis, and explore the significance of conjunctiva transmission of SARS-CoV-2 protection.

Caution of retinal toxicity using chloroquine and hydroxychloroquine in the treatment of COVID-19

Li-Yuan Wang and He Sun — 2020/6/22 14:51:58

“Chloroquine phosphate” was listed as a trial drug in diagnosis and treatment program of COVID-19(trial sixth edition), and the application of chloroquine and hydroxychloroquine treatment for COVID-19 in medical institutions also increased. Chloroquine and hydroxychloroquine have certain retinal toxicity, its mechanism is still unclear, due to different drug tolerance, the risk degree of retinal toxicity in COVID-19 treatment is unclear. Therefore, when using chloroquine and hydroxychloroquine in the treatment of COVID-19, it is recommended to choose the appropriate dosage according to patients' situation, and adopt necessary ophthalmic screening for patients with high risk to prevent the occurrence of retinopathy. In this paper, we described the risk factors, clinical manifestations and screening methods of retinal toxicity caused by chloroquine and hydroxychloroquine, in order to provide references for the safer use of chloroquine and hydroxychloroquine in the treatment of COVID-19.

Analysis of the healthcare-seeking intention of eye patients during COVID-19 outbreak

Hua Feng, Li Cai, Yi Zhang, Yue-Ming Wu and Shu Jiang — 2020/5/25 15:43:04

AIM: To obtain the healthcare-seeking intention of eye patients during COVID-19 outbreak in China.

METHODS: Questionnaire survey was conducted from 2020-02-10 to 2020-02-20, with the combination form of convenience sampling and “Link-tracking related sampling”. We designed the questionnaires, forwarded them to individuals or WeChat group chats, and had the participants fill out the questionnaires on mobile phones, to evaluate their healthcare seeking time and intention, as well as their sense of trust towards online consultation when they had ocular discomforts or trauma.

RESULTS: Totally 458 males(51.3%)and 435 females(48.7%)responded and a total of 893 questionnaires were included. Our data shows that 26.5%, 33.3%, and 40.2% of the respondents respectively from low, medium and high risk area chose online consultation during the COVID-19 outbreak, and the hospital visiting rates were 45.1%, 30.3%, 24.6% in corresponding area. We also demonstrated that gender, age, education level, regional economic development, and the region-level risk classifications have impacts on the consultation methods of the population. Compared to females(39.3%), more males(60.7%)intended to accept online medicine, and the participants from highly developed area preferentially chose virtual medical advisory service(68.2%),while the hospital visiting rates of less developed area(65.2%)was much higher than that in developed area(34.8%). Interestingly, geographic risk level had dramatic influence on the participants' sense of trust towards online consultation.

CONCLUSION: Virtual online consultations were more favorable among Chinese population during COVID-19 outbreak, and were potential to facilitate clinician-patient communication. However, a balance should be achieved between online consultations and face-to-face communication, to avoid human-to-human coronavirus transmission, and to resolve patients' problems.

Ocular infection and detection of coronavirus

Qin Yang, Chang-Jun Lan and Xuan Liao — 2020/4/26 11:24:12

Since the outbreak of severe acute respiratory syndrome coronavirus(SARS-CoV)and Middle East respiratory syndrome coronavirus(MERS-CoV), the study of coronavirus pathogens and the identification of host organisms has been an important task in the medical domain. New coronavirus SARS-CoV-2 appeared in 2019 was more contagious and pathogenic, which quickly attracted a global attention. So far, there have been clinical reports that patients with coronavirus infection can develop ocular symptoms mainly conjunctivitis, and ocular nucleic acid detection has been proposed as an assistant method for early coronavirus identification. This paper reviewed the ocular manifestations and detection of coronavirus to provide references for further research.

Caution of coronavirus transmission through ocular surface

Jin-Xin Song, Yong-Xin Xing, Jie Wu and Hong-Bing Zhang — 2020/3/25 14:45:43

At present, the new coronavirus(COVID-19)epidemic is spreading rapidly in Wuhan city Hubei province of China, and has aroused great attention of the international community. There have been clues that the conjunctiva may be one of the entries for the new coronavirus(SARS-CoV-2). In the absence of clinical evidence on ocular infection with SARS-CoV-2. Therefore, understanding the mechanism and cell receptors of coronavirus transmission through ocular surface and the transmission characteristics of homologous coronavirus can provide some suggestions for appropriately ocular protection and identify COVID-19 coexisting with ocular signs for ophthalmologists during this epidemic disease.

Investiagation of possible mechanism of eye transmission of SARS-CoV-2 based on SARS-CoV

2020/3/25 14:45:43

SARS-CoV-2 has been spreading rapidly since its outbreak in December 2019.Understanding its epidemiological characteristics, especially cutting off transmission routes, is crucial to controlling the spread of the disease. In the study of transmission pathway, the issue of whether SARS-CoV-2 is transmitted through ocular surface tissue has also aroused concerns, but there are still no clinically confirmed cases and laboratory evidence of its infection through ocular surface tissue. New research suggests that the SARS-CoV-2 belongs to the same genus as SARS coronavirus(SARS-CoV), and that it enters cells in the same way as SARS-CoV. This paper reviews the research on SARS-CoV to investigate the possible mechanism of eye transmission of SARS-CoV-2.

Surgical treatment of primary acute angle-closure glaucoma during COVID-19 disease outbreak in Wuhan

Qian Ye, Yan-Ping Song, Hua-Fang Guo and Wen-Qiang Zhang — 2020/11/19 16:34:51

AIM: To summarize the characteristics and treatment of primary acute angle-closure glaucoma during the outbreak of corona virus disease 2019(COVID-19)in Wuhan.

METHODS: Five patients(9 eyes)with primary acute angle-closure glaucoma(APACG)of our hospital were enrolled. Eight eyes with sustained high intraocular pressure(IOP)were given phacoemulsification with goniosynechialysis and one eye in preclinical phase was given YAG laser iridectomy from March 3-20, 2020. The preoperative and postoperative IOP, visual acuity, hospitalization days and complications were reviewed and analyzed.

RESULTS: Three out of five APACG cases were binocular attack. The onset time was 12-40(25.2±11.82)d. The IOP(48.38±3.22mmHg)of eight eyes decreased significantly after surgeries(12.63±1.68mmHg), the difference was statistically significant(t=12.192, P<0.01). The hospitalization time was 2-6(3.8±1.48)d. No COVID-19 infection or severe complications were observed.

CONCLUSION:During the epidemic of COVID-19, phacoemulsification with goniosynechialysis is able to reduce IOP of APACG patients who suffered from longer, heavier and binocular attack in the epidemic area effectively and safely. Strict prevention management can effectively ensure the safety of medical staff and patients, but also increase the difficulty of the surgeries meanwhile.

Analysis on the characteristics and contributing factors of ophthalmic online consultation during the COVID-19 epidemic

2020/10/22 16:19:30

AIM: To analyze the demands, consultation patterns and contributing factors of the patients involved in the ophthalmic on-line consultation during the COVID-19 epidemic to provide reference for the optimization of the ophthalmic online health care system.

METHODS: Prospective observational study. The patients using “expert online consultation” provided by the Zhongshan Ophthalmic Center from February 1 to March 15, 2020 were enrolled. The baseline characteristics were analyzed. For the patients with repeated consultation, we randomly selected the same amount of patients with single consultation as comparison. The baseline characteristics, consultation purposes, disease types, and number of combined eye diseases between the patients with single and repeated consultation were compared, and the contributing factors of patients'consultation pattern were analyzed with statistical test and regression model.

RESULTS: The “expert online consultation” provided 9 831 consultations during the study, 3 919 of which were single consultation while 5 912 of which came from the repeated consultations of 1 967 patients. 1 967 patients with single consultation were randomly selected and compared with the repeated inquirers. The main consultation purposes in the both groups were “return visit”(59.7%, 64.9%). There was no significant difference in age and gender distribution between the patients with single online visit and repeated online visits(P=0.897, 0.482). Compared with the patients with single visit, the patients with repeated visit were less with the purpose of “new-onset discomfort”, more with the purpose of “return visit” and “follow-up after surgery”, more with ocular surface, fundus and uveal diseases, and more with two or more combined eye diseases. Regression analysis showed that the patients with ocular refractive issues tended to have a single consultation, while the patients inquired on previous eye disease and surgery, with fundus or uveal disease tended to have repeated consultations. The number of repeated visits for the patients with diagnosed ophthalmopathy and ophthalmic surgery was higher than that for the patients with new-onset discomfort; the number of repeated visits was lower for the patients with lens and anterior segment diseases, and was higher for the patients with ocular surface diseases.

CONCLUSION: During the COVID-19 epidemic, the main purpose of on-line ophthalmic consultation was return visit for the diagnosed eye diseases. Type of eye disease, consultation purpose and number of combined ophthalmopathies all affected whether the patients repeated the consultation and the repeated times. The arrangement of ophthalmologists in different sub-specialties should be adjusted according to the patients' needs and their consultation patterns.

Prevention and control strategies of ophthalmic emergency and surgery during the epidemic period of coronavirus disease 2019

Lei Guo, Ying-Jie Lin, Xian-Jun Liang and Xi-Qiao Zhang — 2020/10/22 16:19:30

The pneumonia caused by Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2)abbreviated as Coronavirus Disease 2019(COVID-19)has been classified as a Class B infectious disease under the management of Class A infectious diseases in China. COVID-19 caused by hospital-related transmission is not uncommon and poses a serious threat to clinical medical staff and inpatients. This article introduces that ophthalmologists should master the epidemiological characteristics and clinical manifestations of COVID-19, how ophthalmologists cope with the emergency patients in ophthalmology, focus on the key points of infection prevention and control in ophthalmology emergency and surgery, and strengthen specific prevention and control measures, so as to provide reference for infection prevention and control in ophthalmology medical care in the front line of war epidemics.

Intensive online courses promote the development of myopia in children with orthokeratology lens during COVID-19 epidemic

Wei Yang, Bo Liu, Li Chen, Yu-Fei Xu, Shu-Jia Huo and Yong Liu — 2021/6/24 15:28:04

AIM: To study the effect of intensive online courses on myopia in primary and middle school students with orthokeratology-lens during Corona Virus Disease 2019(COVID-19)epidemic.

METHODS:A total of 77 children in myopia with orthokeratology lens in outpatients from February to August 2020 were included in the study. Take a questionnaire to statistics times spending on online course, school class, playing digital electronic good, outdoor activity, homework, sleeping during the COVID-19 epidemic and school time, and analyze the differences of axial length(AL)variation between the COVID-19 epidemic and school time.

RESULTS:For elementary school students, the time spending on online course and school class were 2.69±1.02h and 4.07±0.78h per day respectively(P<0.001), 6.67±1.82h and 6.31±1.19h per day were spent on short-distance use of eyes during the COVID-19 period and school time, respectively(P<0.001). For middle school students, the time spending on online course and school class were 4.35±1.59h and 6.33±0.66h per day respectively(P<0.001), 9.19±2.46h and 7.85±0.81h per day were spent on short-distance use of eyes(P=0.010)during the COVID-19 period and school time, respectively. For elementary school students, the average increase of right eye AL were 0.15±0.09mm and 0.06±0.06mm(P<0.001), the increase of left eye AL were 0.12±0.16mm and 0.07±0.09mm(P=0.048)during the COVID-19 period and school time, respectively. For middle school students, the average increase of right eye were AL 0.08±0.08mm and 0.05±0.05mm(P=0.242), and the average increase of left eye AL were 0.13±0.09mm and 0.04±0.06mm(P<0.001)during the COVID-19 period and school time, respectively. The results showed that both the time of short-distance use of digital electronic product and totally time on close visual study increased significantly during the epidemic period, the growth of AL was faster than that in school time, and the myopia increased rapidly.

CONCLUSION:During the COVID-19 epidemic, intensive online lessons resulted in the time of short-distance use of digital electronic product increase significantly. Meanwhile, the AL growth accelerates significantly compared with that during school time and finally lead to myopia increased.

Analysis of the neonatal dacryocystitis treated by lacrimal passage probing in ambulatory surgery mode during the prevalence of COVID-19

Ning Wang, Heng Li, Li Lin and Bo Long — 2021/10/22 21:57:40

AIM: To analyze the clinical efficacy of neonatal dacryocystitis treated by the lacrimal passage probing(LPB)in ambulatory surgery mode during the prevalence of the COVID-19, and to provide a theoretical basis for the development and promotion of daytime operation mode of LPB in neonatal dacryocystitis.METHODS: The information of 215 cases with neonatal dacryocystitis treated by LPB with ambulatory surgery mode was analyzed retrospectively, including the cure rate, the incidence of complications and adverse reactions, as well as the reasons for not arriving at the hospital after appointment.RESULTS: All patients accomplish LPB surgery and daytime operation management successfully. The success rate of LPB for neonatal dacryocystitis with ambulatory surgery mode was 99.6%, with few postoperative complications and adverse reactions. The reason why the children did not arrive at the hospital after appointment was mainly due to the sickness being catching a cold, pneumonia, diarrhea and other diseases, otherwise, they had to cancel or postponed the appointment.CONCLUSION: In the course of the prevalence of the COVID-19, LPB in the treatment of neonatal dacryocystitis in ambulatory surgery mode is safe, effective and feasible. It can reduce hospitalization expenses, shorten hospitalization time, and is more conducive to the prevention and control of COVID-19, which is worthy of popularization and application.

Ocular manifestations of coronavirus disease 2019(COVID-19)

Han Liu and Hui-Zhen Chen — 2022/11/29 14:58:56

Coronavirus disease 2019(COVID-19)is caused by novel coronavirus(SARS-CoV-2), which is widely prevalent around the world and caused global panic. Evidences show that eye transmission is possible, so the ophthalmic medical staff is more likely to be infected. Ocular manifestations of COVID-19 involve conjunctiva, corneal, sclera, anterior chamber, pupils, retina, optic nerve and visual cortex, extraocular muscles and theirs cranial nerves innervation, orbit and lacrimal system. Viral conjunctivitis is the most common ocular manifestation of COVID-19. In order to protect ophthalmic medical staff from infection and to safely carry out clinical work during the epidemic period of COVID-19, this article summarizes the ocular manifestations of COVID-19, including epidemiology, pathophysiology and clinical manifestation.