Kausar Ayisha, Jan Sahibzada Mohammad, Jaffar Sulman, Tahir Tehreem
Ayisha Kausar, MCPS Ophth, FCPS Ophth Associate Professor Ophthalmology, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
Sahibzada Mohammad Jan, MBBS Demonstrator Basic Health Sciences, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
Pak J Med Sci. 2025 Apr;41(4):1030-1035. doi: 10.12669/pjms.41.4.10939.
Information on the ocular and neuro-ophthalmological manifestations of COVID-19 is relatively sparse. This study was conducted to identify optic nerve dysfunction and ocular involvement in COVID-19 patients.
This prospective case series was conducted from April 2021 to December 2022 at the Ophthalmology Department of a public sector tertiary care hospital in Islamabad, Pakistan. We selected 50 patients with COVID-19 by nonprobability convenience sampling. Detailed systemic/ocular history, ocular examination and optic nerve functions were assessed. Best corrected Snellen's acuity, color vision, contrast sensitivity, light brightness appreciation and Humphrey visual field assessments were done. Detailed slit lamp examination of anterior and posterior segment was also performed.
Ocular symptoms were significantly common in patients with severe systemic disease (n=50, 34% patients, value0.013). The most common complaint was blurred vision (n=6, 12%). Follicular conjunctivitis was found in 60% patients. Optic nerve functions were documented for one hundred eyes of 50 patients. Seventeen eyes had color vision defects (blue yellow) and four eyes had reduced light brightness appreciation. Twenty-nine eyes had visual field defects i.e. paracentral ring scotomas, superior/inferior arcuate defects, or general reduction in sensitivity.
One third of our study population had ocular or neuro-ophthalmic involvement. Although severity of ophthalmic involvement was related to severity of systemic COVID-19 illness and concomitant comorbid disease, ocular involvement was also reported in patients with mild systemic disease or in vaccinated patients. Prolong follow up of these patients should be considered to prevent visual complications.
关于新型冠状病毒肺炎（COVID-19）眼部和神经眼科表现的信息相对较少。本研究旨在确定COVID-19患者的视神经功能障碍和眼部受累情况。
本前瞻性病例系列研究于2021年4月至2022年12月在巴基斯坦伊斯兰堡一家公立三级护理医院的眼科进行。我们通过非概率便利抽样选择了50例COVID-19患者。评估了详细的全身/眼部病史、眼部检查和视神经功能。进行了最佳矫正视力、色觉、对比敏感度、光亮度感知和汉弗莱视野评估。还对眼前段和后段进行了详细的裂隙灯检查。
眼部症状在重症全身性疾病患者中显著常见（n = 50，34%的患者，P值0.013）。最常见的主诉是视力模糊（n = 6，12%）。60%的患者发现有滤泡性结膜炎。记录了50例患者100只眼的视神经功能。17只眼有色觉缺陷（蓝黄色），4只眼光亮度感知降低。29只眼有视野缺损，即中心旁环形暗点、上/下弓形缺损或敏感度普遍降低。
我们研究人群中有三分之一存在眼部或神经眼科受累。尽管眼科受累的严重程度与全身性COVID-19疾病的严重程度及合并症有关，但轻度全身性疾病患者或接种疫苗的患者中也有眼部受累的报道。应考虑对这些患者进行长期随访以预防视觉并发症。
