Department of Ophthalmology, Haseki Training and Research Hospital, University of Health Sciences, Millet Street, 34096, Istanbul, Turkey.
Division of Virology, Department of Medical Microbiology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Int Ophthalmol. 2023 Feb;43(2):451-462. doi: 10.1007/s10792-022-02442-y. Epub 2022 Jul 20.
To assess the presence of viral RNA in conjunctival secretions and tears of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients in terms of a possible ocular transmission route and also to examine whether a difference between the patients with and without ocular surface positivity existed.
A prospective cross-sectional study of 70 consecutive patients who were hospitalized in Haseki Training and Research Hospital with SARS-CoV-2 from February 1 to April 1, 2021, was performed. Tears and conjunctival secretions were collected within 24 h of nasopharyngeal sample collection and examined for SARS-CoV-2 using reverse transcription real-time polymerase chain reaction (qPCR). The clinical data, results of blood tests and nasopharyngeal and conjunctival swabs, and CT findings were evaluated for all patients.
Seventy patients (37 males, 33 females) were included in this study. Tear-conjunctival samples from eight patients (11.42%) yielded positive PCR results although these eight patients had no eye symptoms or conjunctivitis. In patients with positive conjunctival PCR results, cycle threshold values for conjunctival samples were higher than those for nasopharyngeal samples. All findings (except gender) were similar between patients with either positive or negative conjunctival swab samples. All patients with positive conjunctival swab samples were male; however, the male ratio in patients with negative conjunctival swab samples was only 46.77%.
In our study, the rate of conjunctival swab PCR positivity was 11.42%. It appears that even in the absence of ocular symptoms, SARS-CoV-2 virus may be present on the ocular surface; therefore, the ocular surface may be a significant viral transmission route.
评估严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染患者的结膜分泌物和泪液中病毒 RNA 的存在情况，以探讨眼部传播途径的可能性，并研究存在眼部表面阳性的患者与不存在眼部表面阳性的患者之间是否存在差异。
我们对 2021 年 2 月 1 日至 4 月 1 日期间在哈塞基培训和研究医院因 SARS-CoV-2 住院的 70 例连续患者进行了前瞻性横断面研究。在采集鼻咽样本后 24 小时内采集泪液和结膜分泌物，并使用逆转录实时聚合酶链反应（qPCR）检测 SARS-CoV-2。对所有患者的临床数据、血液检查结果、鼻咽和结膜拭子以及 CT 结果进行了评估。
本研究共纳入 70 例患者（37 名男性，33 名女性）。尽管这 8 例患者没有眼部症状或结膜炎，但有 8 例患者的泪-结膜样本的 PCR 结果呈阳性。在结膜 PCR 结果阳性的患者中，结膜样本的循环阈值高于鼻咽样本。结膜拭子样本阳性和阴性的患者之间的所有发现（除性别外）均相似。所有结膜拭子样本阳性的患者均为男性；然而，结膜拭子样本阴性的患者中男性的比例仅为 46.77%。
在我们的研究中，结膜拭子 PCR 阳性率为 11.42%。即使没有眼部症状，SARS-CoV-2 病毒也可能存在于眼表面；因此，眼表面可能是一个重要的病毒传播途径。
