Zong Yuan, Zou Yaru, Yang Mingming, Zhang Jing, Ye Zizhen, Deng Jiaxin, Ohno-Matsui Kyoko, Kamoi Koju
Department of Ophthalmology, Zhongshan Torch Development Zone People's Hospital, Zhongshan 528436, China.
Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan.
Vaccines (Basel). 2025 May 21;13(5):546. doi: 10.3390/vaccines13050546.
Poxvirus infections, particularly those caused by the monkeypox virus, have emerged as significant public health threats. Ocular manifestations constitute a severe potential clinical complication associated with these infections, potentially resulting in permanent visual impairment in afflicted patients. This review aimed to examine the clinical spectrum of ocular manifestations associated with mpox and other poxvirus infections and to evaluate current management strategies alongside emerging therapeutic interventions and prevention strategies. A comprehensive literature search was performed across major databases to identify studies reporting ocular involvement in poxviral infections. Ocular involvement in poxviral infections ranges from mild conjunctivitis and eyelid lesions to severe keratitis with potential vision loss. Mpox-related ocular manifestations are more prevalent in unvaccinated and immunocompromised individuals. Although early antiviral intervention and supportive care are critical, clinical outcomes vary considerably across viral clades. Emerging evidence indicates that tecovirimat may reduce lesion severity, although its impact on accelerating recovery remains limited. Moreover, vaccine strategies, particularly the MVA-BN (JYNNEOS) vaccine, appear to decrease ocular complications, despite regional disparities in access and implementation. Ocular complications pose a significant clinical challenge in mpox and related poxviral infections. This review highlights the need for early diagnosis and integrated treatment approaches that combine antiviral therapy, supportive care, and targeted vaccination. Further research is essential to refine treatment protocols and assess the long-term outcomes in diverse patient populations.
痘病毒感染，尤其是由猴痘病毒引起的感染，已成为重大的公共卫生威胁。眼部表现是与这些感染相关的严重潜在临床并发症，可能导致患病患者永久性视力损害。本综述旨在研究与猴痘和其他痘病毒感染相关的眼部表现的临床谱，并评估当前的管理策略以及新兴的治疗干预措施和预防策略。在各大数据库中进行了全面的文献检索，以确定报告眼部受累于痘病毒感染的研究。痘病毒感染的眼部受累范围从轻度结膜炎和眼睑病变到严重角膜炎并伴有潜在视力丧失。与猴痘相关的眼部表现在未接种疫苗和免疫功能低下的个体中更为普遍。尽管早期抗病毒干预和支持治疗至关重要，但不同病毒分支的临床结果差异很大。新出现的证据表明，特考韦瑞可能会降低病变严重程度，尽管其对加速恢复的影响仍然有限。此外，疫苗策略，特别是MVA-BN（JYNNEOS）疫苗，似乎可以减少眼部并发症，尽管在获取和实施方面存在地区差异。眼部并发症在猴痘和相关痘病毒感染中构成了重大的临床挑战。本综述强调了早期诊断和综合治疗方法的必要性，这些方法应结合抗病毒治疗、支持治疗和针对性疫苗接种。进一步的研究对于完善治疗方案和评估不同患者群体的长期结果至关重要。
