Huang Duliurui, Xuan Weixia, Li Zhijie
Department of Ophthalmology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
Viruses. 2025 Jan 6;17(1):68. doi: 10.3390/v17010068.
COVID-19, caused by SARS-CoV-2, has presented formidable challenges to global health since its emergence in late 2019. While primarily known for respiratory symptoms, it can also affect the ocular surface. This review summarizes the effects of SARS-CoV-2 on ocular surface immunity and inflammation, focusing on infection mechanisms, immune responses, and clinical manifestations. Ocular symptoms, though uncommon, include conjunctivitis, dry eye, and blurred vision. SARS-CoV-2 binds to ACE2 receptors in ocular surface epithelial cells, facilitating viral entry, replication, and local dissemination. The innate immune responses involving corneal epithelial cells and immune cells are discussed, alongside mechanisms of antigen presentation and adaptive immunity. The review also examines the roles of cytokines and chemokines in mediating ocular surface inflammation and explores the impact of cytokine storms and chronic inflammation on ocular health. Additionally, the interplay between systemic and ocular immune responses is highlighted, analyzing how systemic COVID-19 inflammation influences ocular surface health. These insights underscore the broader implications of COVID-19 beyond localized ocular infection. By consolidating current findings, this review aims to guide preventive and therapeutic strategies while identifying directions for future research to mitigate the ocular consequences of COVID-19.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）自2019年末出现以来，给全球健康带来了巨大挑战。虽然它主要以呼吸道症状而闻名，但也会影响眼表。本综述总结了SARS-CoV-2对眼表免疫和炎症的影响，重点关注感染机制、免疫反应和临床表现。眼部症状虽然不常见，但包括结膜炎、干眼症和视力模糊。SARS-CoV-2与眼表上皮细胞中的血管紧张素转换酶2（ACE2）受体结合，促进病毒进入、复制和局部传播。文中讨论了涉及角膜上皮细胞和免疫细胞的固有免疫反应，以及抗原呈递和适应性免疫的机制。该综述还研究了细胞因子和趋化因子在介导眼表炎症中的作用，并探讨了细胞因子风暴和慢性炎症对眼部健康的影响。此外，还强调了全身免疫反应和眼部免疫反应之间的相互作用，分析了全身性COVID-19炎症如何影响眼表健康。这些见解强调了COVID-19的影响超出局部眼部感染的范围。通过整合当前的研究结果，本综述旨在指导预防和治疗策略，同时确定未来研究的方向，以减轻COVID-19对眼部的影响。
