Severe Covid-19 survivors should have their eyes examined, study suggests

Doctors warn that covid-19 may be able to cause persistent eye problems. A new study suggests that some people who survive a severe infection may develop growths on the back of their eyes that could lead to vision loss. It is not yet known how covid-19 might cause these growths, or whether people with milder covid-19 are also at risk for this complication.

Researchers from the French Society of Neuroradiology looked at medical records of some patients with severe covid-19. These patients had all undergone brain MRIs at some point in their illness, which allowed researchers to look for potential abnormalities in and around the eye.

In total, they looked at data from 129 patients in 16 hospitals who were infected during the first wave of the pandemic in France, between March and May 2020. Nine of these patients (7%) showed signs of nodules on the skin. back of the eyeball. , most with growths on both eyes. Eight patients had also been in the intensive care unit.

There have been occasional reports of people with covid-19 with abnormal test results or eye-related health issues, such as conjunctivitis (pink eye). But the authors say theirs is the first study to try to estimate how often this could happen using MRI data. The results should be enough to convince doctors to look for potential eye problems in patients with severe disease, they add, especially since they might be difficult to spot at first.

“Serious eye problems can go unnoticed as these patients are often treated in intensive care units for much more serious and potentially life-threatening conditions,” they wrote in their article. published Tuesday in the journal Radiology. “Our data support the need for screening and follow-up of these patients to provide appropriate treatment and improve management of potentially serious ophthalmologic manifestations.”

Results have their limits. They cannot conclusively show that covid-19 led to these eye growths, or explain how this could have happened if the disease was responsible for it. One theory expressed by the authors is that the infection reached the eyes and directly damaged the retina. Another is that inflammation indirectly caused by infection is the main culprit. It is even possible that the practice of lying patients on their stomachs (the supine position) – a common procedure that has been shown to help patients breathe more easily – could have contributed to faulty drainage of the veins connected to the eye. . Pre-existing circulation problems, common in diabetic patients, could also be a factor.

Researchers are already working on future studies to better understand these potential complications. This includes the proactive study of patients with severe covid-19 from more recent waves of the pandemic, which would confirm whether these growths and other eye problems are really the result of the disease and not a previous hidden problem. Survivors with these growths are also followed to see if they are at increased risk for long-term vision problems. And researchers are continuing a similar study, focusing on patients with mild to moderate covid-19.

“We have launched a prospective study with high resolution MR images dedicated to the exploration of the eye and the orbit in patients with mild to moderate COVID,” said lead author Augustin Lecler, radiologist and professor associated with the University of Paris, in a declaration published by the Radiological Society of North America, which publishes Radiology. “Therefore, we will be able to know whether our results were specific to patients with severe COVID or not.”