French Study Reveals That COVID-19 Causes Potentially Dangerous Eye Abnormalities Such As The Formation Of Nodules In The Macular Region!
A new French study by researchers from the Foundation Adolphe de Rothschild Hospital in Paris have found that COVID-19 causes a potentially dangerous eye condition in a segment of patients that are severely infected in which the formation of nodules are observed in the macular regions of the eyes.
The study findings report 9 patients (1/9 [11%] woman and 8/9 [89%] men, mean age 56 ± 13 years) with globe MRI abnormalities obtained from a multicenter cohort of 129 patients presenting with severe COVID-19 disease
from March 4th to May 1st, 2020. 9/129 (7%) patients had one or several FLAIR-WI hyperintense nodules of the posterior pole of the globe. All patients had nodules in the macular region, 8/9 (89%) had bilateral nodules, 2/9 (22%) had nodules outside the macular region. Screening of these patients might improve the management of potentially severe ophthalmological manifestations of the virus.
The study findings were published in the peer reviewed journal: Radiology.
The study team utilizing MRI had found significant abnormalities in the eyes of certain individuals with severe COVID-19.
The research findings support the need for eye screening in these patients to provide appropriate treatment and management of potentially severe ophthalmological manifestations of COVID-19.
To date, the COVID-19 pandemic has affected more than 109 million people since it began early in 2020.
Although the SARS-CoV-2 coronavirus primarily attacks the lungs, it has been linked with eye abnormalities like conjunctivitis, also known as pink eye, and retinopathy, a disease of the retina that can result in a loss of vision.
Ocular or eye abnormalities visible on MRI exams have been reported but there is limited research on the nature and frequency of these abnormalities.
In order to find out more, the French Society of Neuroradiology (SFNR) initiated a study of 129 patients with severe COVID-19 who underwent brain MRI.
Interestingly of the 129 patients, nine (7%) had abnormal MRI findings of the globe, or eyeball. The MRI scans showed one or more nodules in the back part, or posterior pole, of the eyeball. Eight of the nine patients had spent time in the intensive care unit (ICU) for COVID-19.
Lead author Dr Augustin Lecler, M.D., Ph.D., associate professor at the University of Paris and neuroradiologist from the Department of Neuroradiology at the Foundation Adolphe de Rothschild Hospital in Paris told Thailand Medical News, "We showed that a few patients with severe COVID-19 from the French COVID-19 cohort had one or several nodules of the posterior pole of the globe. This is the first time these findings have been described using MRI."
Importantly all nine patients had nodules in the macular region, the area in the back of the eye responsible for our central vision. Eight had nodules in both eyes.
The study findings suggest that screening should be considered in all patients with severe COVID-19 to detect these nodules. In clinical practice, this screening could include dedicated explor
ation of the eyes with high-resolution MRI, the researchers said.
Further recommended exams include fundoscopy, which uses a magnifying lens and a light to check the back of the inside of the eye, and optical coherence tomography, a noninvasive test that provides a 3-D picture of the structure of the eye.
The study team noted that severe eye problems might largely go unnoticed in the clinic, as COVID-19 patients hospitalized in the ICU are often being treated for much more severe, life-threatening conditions.
Dr Lecler further added, "The research findings advocate for screening of all patients hospitalized in the ICU for severe COVID-19. We believe those patients should receive specific eye-protective treatments."
To date, the detailed mechanism behind nodule formation remains unknown, the researchers said, although it could be related to inflammation triggered by the virus. Inadequate drainage of the veins of the eyes, a problem found in patients who spend time in the ICU in the prone position or intubated, may also be a factor.
It was observed that seven of the nine patients with eye abnormalities in the study had been placed in a prone position in the ICU for an extended time.
The study team is performing follow-up clinical and MRI examinations in the survivors to monitor the nodules and see if they carry any clinical consequences such as vision loss or visual field impairment.
The team is also performing MRI examinations in new patients with severe COVID-19 from the second and third waves of the pandemic, using more comprehensive ophthalmological tests to correlate with the MRI results.
Also the effects on patients with moderate COVID-19 are currently under investigation.
Dr Lecler added, "We have launched a prospective study with dedicated high-resolution MR images for exploring the eye and orbit in patients with mild to moderate COVID. Therefore, we will be able to know whether our findings were specific to severe COVID patients or not."
The study findings support previous research that showed COVID-19 exacts a greater toll in individuals with existing health problems. Of the nine patients with eye nodules, two had diabetes, six were obese and two had hypertension.
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