Incidence and Clinical Characteristics of COVID-19 Ophthalmopathy Following the Termination of Dynamic Zero COVID-19 Strategy in China

ABSTRACT

Ocular involvement is not uncommon in patients with COVID-19. However, the incidence of COVID-19 ophthalmopathy in COVID-19 patients is still not clear. In this prospective case series study, we recruited 2445 consecutive cases presenting at Neuro-ophthalmology clinic of our Eye Center during the last resurgence of SARS-CoV-2 infection from 8 December 2022 to 15 March 2023 in China, 149 cases were diagnosed as COVID-19 ophthalmopathy, 87 cases were female, with a mean age of 43.2 years, and the mean follow-up time was 15.4 weeks. One hundred and twenty of 149 cases suffered from systemic symptoms mostly manifesting as fever, cough and muscle pain prior to or soon after ocular involvement. The most common COVID-19 ophthalmopathy was optic neuritis (51/149), followed by acute zonal occult outer retinopathy complex disease (31/149), uveitis (17/149), ocular mobility disorder-related (third, fourth, or sixth) cranial nerve neuritis (15/149), anterior ischaemic optic neuropathy (9/149), retinal artery occlusion (8/149), retinal microangiopathy including retinal haemorrhage and cotton wool spot (8/149), viral conjunctivitis (7/149), retinal vein occlusion (3/149), viral keratitis (2/149), ptosis (2/149), and other rare ocular diseases. Except 5 cases with central retinal artery occlusion, other 144 COVID-19 ophthalmopathy cases showed good response to steroid therapy. Our study revealed an incidence of 6.09% for COVID-19 ophthalmopathy in outpatients at our Neuro-ophthalmology clinic during last resurgence of COVID-19 in China, and demonstrated that SARS-CoV-2 infection could induce an initial onset or a relapse of ophthalmic diseases, and that ocular involvement might manifest as the initial or even the only presentation of COVID-19.

KEYWORDS:

• Corona virus disease 2019
• severe acute respiratory syndrome coronavirus 2
• Incidence
• ophthalmopathy
• optic neuritis
• acute zonal occult outer retinopathy complex disease
• anterior ischaemic optic neuropathy

Acknowledgments

The authors would like to thank all participants for their trust and cooperation in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

CS and ZL designed the study, collected and analysed the data, wrote and revised the manuscript.

Consent for publication

Written informed consents were obtained from all patients for publication of this study and any accompanying images. A copy of the written consents is available for review by the editor of this journal.

Data availability statement

All data generated or analysed during this study are included in this published article [and its supplementary information files].

Ethics approval and consent to participate

Institutional review board approvals were obtained from the Second Affiliated Hospital of Zhejiang University School of Medicine. This study was conducted according to the tenets of the Declaration of Helsinki. Informed consents were obtained from all participants.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.