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新型冠状病毒肺炎在后段眼的表现——最新情况。

Manifestations of COVID-19 in the posterior eye segment - Up-to-date.

作者信息

Marzoog Basheer Abdullah

机构信息

World-Class Research Center "Digital Biodesign and Personalized Healthcare," I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

出版信息

Oman J Ophthalmol. 2024 Jun 27;17(2):166-172. doi: 10.4103/ojo.ojo_212_22. eCollection 2024 May-Aug.

Abstract

Since coronavirus disease infection-19 (COVID-19) entry to the cells is angiotensin enzyme receptor (ACEII) dependent, extrapulmonary manifestations have been suspected. Ocular manifestations reported in several studies to involve the anterior as well as posterior eye segments. However, the predominance of the anterior eye segment reduced the attention of the scientific community on the posterior eye segment. Our results showed that the incidence of changes in the posterior eye segment is 1/5 of the anterior eye segment. Posterior eye segment manifestations include acute macular neuroretinopathy and paracentral middle maculopathy, central retinal vein/artery occlusion, reactivation of previous uveitis, varicella zoster virus-related acute retinal necrosis in an immunocompromised patient, chorioretinitis, macular hemorrhage, paracentral acute middle maculopathy, retinal detachment, and vitritis with outer retinal abnormalities. The pathogenesis of posterior eye segment manifestations under COVID-19 includes viremia, autoimmune vasculitis, hyperimmune response, coagulopathy, and cytokine storm. A full ophthalmological examination is crucial for patients recovering from COVID-19. The paper provided up-to-date manifestations with potential underlying pathophysiological mechanisms of development, as well as pathogenetic therapy.

摘要

由于新型冠状病毒肺炎(COVID-19)进入细胞依赖血管紧张素酶受体(ACEII),因此人们怀疑存在肺外表现。多项研究报告的眼部表现涉及眼前节和眼后节。然而,眼前节表现更为常见,这降低了科学界对眼后节的关注。我们的结果表明,眼后节变化的发生率是眼前节的1/5。眼后节表现包括急性黄斑神经视网膜病变和黄斑旁中病变、视网膜中央静脉/动脉阻塞、既往葡萄膜炎复发、免疫功能低下患者中与水痘带状疱疹病毒相关的急性视网膜坏死、脉络膜视网膜炎、黄斑出血、黄斑旁急性中病变、视网膜脱离以及伴有外层视网膜异常的玻璃体炎。COVID-19情况下眼后节表现的发病机制包括病毒血症、自身免疫性血管炎、高免疫反应、凝血病和细胞因子风暴。全面的眼科检查对从COVID-19中康复的患者至关重要。本文提供了最新的表现、潜在的发展病理生理机制以及致病治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08e/11309540/23cc91d39e8c/OJO-17-166-g001.jpg

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