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Manifestações oculares associadas à COVID-19 : uma revisão narrativa
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Introdução: Em dezembro de 2019 surgiu, na China, um novo coronavírus - SARS-CoV-2, responsável por provocar a doença COVID-19. Embora pouco frequentes, têm sido descritos relatos que demonstram uma associação entre o SARS-CoV-2 e o olho, existindo estudos que descrevem as complicações oculares decorrentes desta infeção. O objetivo deste trabalho é realizar uma revisão narrativa com ênfase na doença, porta de entrada e implantação do vírus a nível ocular e manifestações oculares reportadas secundárias à COVID-19.
Métodos: Foi realizada uma pesquisa bibliográfica na PubMed e Cochrane, usando as palavras-chave “SARS-CoV-2” e “COVID-19”, em associação com - “ophthalmology”, “conjunctivitis”, “ocular surface”, “uveitis”, “retina”, “vasculitis”, “ophthalmoparesis”, “optic nerve”, “anterior ischemic optic neuropathy”, “retinal vein occlusion”, “retinal artery occlusion”, “eye” e “eyelid”. Todos os artigos foram selecionados pelo título e resumo, procedendo-se à avaliação do texto completo quando elegíveis.
Resultados: Noventa e um artigos foram analisados e sessenta incluídos nesta revisão. Alguns destes estudos relataram uma associação entre a infeção por SARS-CoV-2 e a taxa de positividade para a pesquisa de RNA viral em lágrimas e secreções conjuntivais de pacientes com COVID-19. As manifestações oculares associadas à COVID-19 são infrequentes atingindo 6-12%. O segmento anterior do olho, nomeadamente a conjuntiva, é o local mais afetado, sendo a conjuntivite a doença mais frequentemente observada. A córnea, úvea, retina e nervo ótico também podem ser afetados, ainda que infrequentemente. Foi postulado que o processo inflamatório provocado pelo vírus, a terapêutica instituída e as condições de decúbito ventral a que os doentes possam ser submetidos durante o internamento são as possíveis causas para as manifestações oculares observadas.
Discussão: Os sinais e sintomas oculares podem ser os primeiros ou mesmo os únicos a aparecer em alguns doentes infetados. Assim, torna-se fundamental valorizar e conhecer as manifestações oculares associadas à COVID-19 e tomar as devidas precauções para evitar a transmissão viral a nível ocular, utilizando os óculos para proteção ocular, além do restante material de proteção recomendado.
Introduction: In December 2019, a new coronavirus emerged in China - SARS-CoV-2 -, responsible for causing the COVID-19 disease. Although infrequent, reports have been described and demonstrate an association between SARS-CoV-2 and the eye, and there are studies that describe the ocular complications resulting from this infection. The aim of this work was to perform a narrative review with an emphasis on the disease, gateway, and implantation of the virus at the ocular level and report ocular manifestations secondary to COVID-19. Methods: A literature search was performed on PubMed and Cochrane, using the keywords “SARS-CoV-2” and “COVID-19”, in association with - “ophthalmology”, “conjunctivitis”, “ocular surface”, “uveitis”, “retina”, “vasculitis”, “ophthalmoparesis”, “optic nerve”, “anterior ischemic optic neuropathy”, “retinal vein occlusion”, “retinal artery occlusion”, “eye” and “eyelid”. All articles were selected by title and abstract, and the full text was evaluated when eligible. Results: Ninety-one articles were analyzed and sixty selected to be included in the review. Some of the studies reported an association between SARS-CoV-2 infection and the positivity rate for viral RNA screening in tears and conjunctival secretions from COVID-19 patients. Ocular manifestations associated with COVID-19 are infrequent reaching 6-12%. The anterior segment of the eye, namely the conjunctiva, was the most affected site and conjunctivitis the most frequently observed disease. The cornea, uvea, retina and optic nerve, were also reported to be affected, although infrequently It has been postulated that the inflammatory process caused by the virus, the therapy instituted and the conditions of prone position which patients may be submitted during hospitalization are possible causes for the observed ocular manifestations. Discussion: Ocular signs and symptoms may be the first or even the only ones to appear in some infected patients. Thus, it is essential to value and know the ocular manifestations associated with COVID-19 and to take the necessary precautions to avoid viral transmission at the eye level, using eye protection glasses, in addition to the remaining recommended protective material.
Introduction: In December 2019, a new coronavirus emerged in China - SARS-CoV-2 -, responsible for causing the COVID-19 disease. Although infrequent, reports have been described and demonstrate an association between SARS-CoV-2 and the eye, and there are studies that describe the ocular complications resulting from this infection. The aim of this work was to perform a narrative review with an emphasis on the disease, gateway, and implantation of the virus at the ocular level and report ocular manifestations secondary to COVID-19. Methods: A literature search was performed on PubMed and Cochrane, using the keywords “SARS-CoV-2” and “COVID-19”, in association with - “ophthalmology”, “conjunctivitis”, “ocular surface”, “uveitis”, “retina”, “vasculitis”, “ophthalmoparesis”, “optic nerve”, “anterior ischemic optic neuropathy”, “retinal vein occlusion”, “retinal artery occlusion”, “eye” and “eyelid”. All articles were selected by title and abstract, and the full text was evaluated when eligible. Results: Ninety-one articles were analyzed and sixty selected to be included in the review. Some of the studies reported an association between SARS-CoV-2 infection and the positivity rate for viral RNA screening in tears and conjunctival secretions from COVID-19 patients. Ocular manifestations associated with COVID-19 are infrequent reaching 6-12%. The anterior segment of the eye, namely the conjunctiva, was the most affected site and conjunctivitis the most frequently observed disease. The cornea, uvea, retina and optic nerve, were also reported to be affected, although infrequently It has been postulated that the inflammatory process caused by the virus, the therapy instituted and the conditions of prone position which patients may be submitted during hospitalization are possible causes for the observed ocular manifestations. Discussion: Ocular signs and symptoms may be the first or even the only ones to appear in some infected patients. Thus, it is essential to value and know the ocular manifestations associated with COVID-19 and to take the necessary precautions to avoid viral transmission at the eye level, using eye protection glasses, in addition to the remaining recommended protective material.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Conjuntivite COVID-19 SARS-CoV-2 Transmissão ocular Oftalmologia