Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.
Curr Opin Ophthalmol. 2021 Jul 1;32(4):338-342. doi: 10.1097/ICU.0000000000000773.
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious coronavirus causing the COVID-19 pandemic. Although airborne spread through infectious respiratory droplets is the primary source of transmission, recent literature has suggested the ocular surface may be able to harbor viral particles. Here, we aim to discuss how SARS-CoV-2 affects the ocular surface and updated guidance on how SARS-CoV-2 transmission should be considered in the setting of eye banking and corneal transplantation procedures.
SARS-CoV-2 RNA can be found on the ocular surface, which may suggest the eye as a site of viral replication. However, there is poor correlation between PCR positivity on the ocular surface and ocular symptoms. To date, although viral particles can be found on the ocular surface, use of standard antiseptic procedures during corneal tissue procurement appears to sufficiently reduce viral load. In addition, preprocedure testing may further decrease the chances of transplanting an infected cornea without significantly impacting the overall accessibility to corneal tissue by decreasing the donor pool.
Corneal transplantation remains a well tolerated and highly successful procedure with no evidence of viral transmission with transplantation. Although the ocular surface has the required receptors to allow for viral replication, there is no clear evidence that the eye is a site for primary viral infection.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是一种高度传染性的冠状病毒，引发了 COVID-19 大流行。尽管通过传染性呼吸道飞沫进行空气传播是主要的传播源，但最近的文献表明，眼表可能藏匿着病毒颗粒。在这里，我们旨在讨论 SARS-CoV-2 如何影响眼表，并就眼库和角膜移植手术中应如何考虑 SARS-CoV-2 传播提供最新指南。
眼表可检测到 SARS-CoV-2 RNA，这表明眼睛可能是病毒复制的部位。然而，眼表 PCR 阳性与眼部症状之间相关性较差。迄今为止，尽管眼表可发现病毒颗粒，但在获取角膜组织时使用标准的防腐程序似乎足以降低病毒载量。此外，术前检测可进一步降低移植感染角膜的几率，而不会通过减少供体库显著影响角膜组织的整体可及性。
角膜移植仍然是一种耐受性良好且成功率很高的手术，没有证据表明移植会导致病毒传播。尽管眼表具有允许病毒复制的必需受体，但没有明确证据表明眼睛是原发性病毒感染的部位。
