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1.
Int Ophthalmol ; 43(4): 1369-1374, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36152172

RESUMO

OBJECTIVES: To assess the relationship between orbital wall fractures connecting to  paranasal sinuses (OWF-PNS) and SARS-CoV-2 ocular surface contamination (SARS-CoV-2-OSC) in asymptomatic COVID-19 patients. METHODS: This was a prospective case-control study enrolling two asymptomatic COVID-19 patient cohorts with vs. without OWF-PNS in the case-control ratio of 1:4. All subjects were treated in a German level 1 trauma center during a one-year interval. The main predictor variable was the presence of OWF-PNS (case/control); cases with preoperative conjunctival positivity of SARS-CoV-2 were excluded to rule out the possibility of viral dissemination via the lacrimal gland and/or the nasolacrimal system. The main outcome variable was laboratory-confirmed SARS-CoV-2-OSC (yes/no). Descriptive and bivariate statistics were computed with a statistically significant P ≤ 0.05. RESULTS: The samples comprised 11 cases and 44 controls (overall: 27.3% females; mean age, 52.7 ± 20.3 years [range, 19-85]). There was a significant association between OWF-PNS and SARS-CoV-2-OSC (P = 0.0001; odds ratio = 20.8; 95% confidence interval = 4.11-105.2; R-squared = 0.38; accuracy = 85.5%), regardless of orbital fracture location (orbital floor vs. medial wall versus both; P = 1.0). CONCLUSIONS: Asymptomatic COVID-19 patients with OWF-PNS are associated with a considerable and almost 21-fold increase in the risk of SARS-CoV-2-OSC, in comparison with those without facial fracture. This could suggest that OWF-PNS is the viral source, requiring particular attention during manipulation of ocular/orbital tissue to prevent viral transmission.


Assuntos
COVID-19 , Aparelho Lacrimal , Ducto Nasolacrimal , Fraturas Orbitárias , Estudos de Casos e Controles , Fraturas Orbitárias/complicações , Fraturas Orbitárias/diagnóstico , SARS-CoV-2 , Seios Paranasais , Estudos Prospectivos , Aparelho Lacrimal/virologia , Ducto Nasolacrimal/virologia , Idoso de 80 Anos ou mais , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Portador Sadio
2.
Eur J Ophthalmol ; 31(1): 138-143, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31630558

RESUMO

PURPOSE: To evaluate the role of viral infections in the pathogenesis of primary acquired nasolacrimal duct obstruction. METHODS: The study included 48 patients diagnosed with primary acquired nasolacrimal duct obstruction undergoing dacryocystorhinostomy surgery. Prior to dacryocystorhinostomy surgery, nasal swab sample was taken from the inferior meatus at the same side. During dacryocystorhinostomy, tissue biopsy sample (2 × 2 mm) was taken from the junction area of the lacrimal sac and nasolacrimal duct. Following nucleic acid extraction, polymerase chain reaction was performed. RESULTS: The patients consisted of 9 (18.8%) men and 39 (81.2%) women with a mean age of 51.0 ± 14.3 years. Qualitative polymerase chain reaction showed viral genome in the nasal swabs of 10 (20.8%) patients, including coronavirus 229E (three cases), coronavirus HKU1 (two cases), respiratory syncytial virus (two cases), coronavirus OC43 (one case), coronavirus NL63 (one case), and adenovirus (one case). In the dacryocystorhinostomy samples, viral genomes were detected in four (8.3%) cases, including respiratory syncytial virus (two cases), coronavirus HKU1 (one case), and adenovirus (one case). There was a statistically significant agreement between nasal mucosal swab and dacryocystorhinostomy biopsy samples in terms of respiratory syncytial virus positivity (kappa = 1.000, p = 0.001). CONCLUSION: Although the viral genome was detected in the samples, a direct relationship between viruses and pathogenesis of primary acquired nasolacrimal duct obstruction could not be revealed because of the low number of positive results. However, considering the profibrotic characteristics of specific viruses such as respiratory syncytial virus and adenovirus, viral infections may be one of the many predisposing factors of primary acquired nasolacrimal duct obstruction.


Assuntos
Adenovírus Humanos/genética , Coronavirus/genética , Genoma Viral/genética , Obstrução dos Ductos Lacrimais/virologia , Mucosa Nasal/virologia , Ducto Nasolacrimal/virologia , Vírus Sinciciais Respiratórios/genética , Adenovírus Humanos/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Coronavirus/isolamento & purificação , Dacriocistorinostomia , Feminino , Humanos , Obstrução dos Ductos Lacrimais/terapia , Masculino , Pessoa de Meia-Idade , Ducto Nasolacrimal/cirurgia , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Vírus Sinciciais Respiratórios/isolamento & purificação , Adulto Jovem
5.
Klin Monbl Augenheilkd ; 237(5): 675-680, 2020 May.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-32375197

RESUMO

PURPOSE: To perform a systematic analysis of articles on the ophthalmological implications of the global COVID-19 pandemic. METHODS: PubMed.gov was searched for relevant articles using the keywords "COVID-19", "coronavirus", and "SARS-CoV-2" in conjunction with "ophthalmology" and "eye". Moreover, official recommendations of ophthalmological societies were systematically reviewed, with a focus on the American Academy of Ophthalmology (AAO) and the Royal College of Ophthalmologists (RCOphth). RESULTS: As of April 16, 2020, in total, 21 peer-reviewed articles on the ophthalmological aspects of COVID-19 were identified. Of these, 12 (57.1%) were from Asia, 6 (28.6%) from the United States of America, and 3 (14.3%) from Europe. There were 5 (23.8%) original studies, 10 (47.6%) letters, 3 (14.2%) case reports, and 3 (14.2%) reviews. These articles could be classified into the topics "Modes and prevention of (ocular) transmission", "Ophthalmological manifestations of COVID-19", "Clinical guidance concerning ophthalmological practice during the COVID-19 pandemic", and "Practical recommendations for clinical infrastructure". Practical recommendations could be extracted from official statements of the AAO and the RCOphth. CONCLUSION: Within a short period, a growing body of articles has started to elucidate the ophthalmological implications of COVID-19. As the eye can represent a route of infection (actively via tears and passively via the nasoacrimal duct), ophthalmological care has to undergo substantial modifications during this pandemic. In the eye, COVID-19 can manifest as keratoconjunctivitis.


Assuntos
Infecções por Coronavirus , Ceratoconjuntivite , Ducto Nasolacrimal/virologia , Oftalmologia , Pandemias , Pneumonia Viral , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Lágrimas/virologia , Betacoronavirus/patogenicidade , COVID-19 , Infecções por Coronavirus/complicações , Infecções por Coronavirus/transmissão , Humanos , Ceratoconjuntivite/virologia , Pneumonia Viral/complicações , Pneumonia Viral/transmissão , SARS-CoV-2
6.
Am J Surg Pathol ; 40(4): 519-28, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26735858

RESUMO

High-risk human papilloma virus (HR-HPV) is a well-established causative agent of oropharyngeal squamous cell carcinoma (SCC). In addition, HR-HPV has occasionally been reported to be present in dysplastic and malignant lesions of the conjunctiva and lacrimal sac, although its overall incidence and etiological role in periocular SCC are controversial. Sequential surgical samples of 52 combined cases of invasive SCC (I-SCC) and SCC in situ (SCCIS) from 2 periocular sites (conjunctiva and lacrimal sac) diagnosed over a 14-year period (2000 to 2014) were selected for evaluation, and relevant patient characteristics were documented. p16 immunohistochemistry was performed as a screening test. All p16-positive cases were further evaluated for HR-HPV using DNA in situ hybridization (DNA ISH), and a subset was also analyzed by polymerase chain reaction (PCR). Of 43 ocular surface squamous neoplasias (OSSNs), 30% (n=13; 8 SCCIS and 5 I-SCC cases) were positive for HR-HPV. HPV-positive OSSNs occurred in 8 men and 5 women with a mean age of 60 years (range, 39 to 94 y). HPV type-16 was detected in all conjunctival cases evaluated by PCR. All 5 conjunctival I-SCCs were nonkeratinizing (n=4) or partially keratinizing (n=1) and managed by simple excision. In contrast, HPV-negative conjunctival I-SCCs were predominantly keratinizing (11 keratinizing and 2 nonkeratinizing). Of 9 lacrimal sac I-SCCs (LSSCCs), 66.7% (n=6) were positive for HR-HPV by p16 and DNA ISH; HPV subtypes were HPV-16 (n=5) and HPV-58 (n=1). In addition, 2 p16-positive cases with negative DNA ISH results were HR-HPV positive (HPV-16 and HPV-33) when evaluated by PCR, suggesting that the rate of HR-HPV positivity among the LSSCCs may be as high as 89% (n=8). The combined group of HR-HPV-positive LSSCCs was seen in 4 men and 4 women with a mean age of 60 years (range, 34 to 71 y). Seven of the 8 HPV-positive LSSCCs (87.5%) had a nonkeratinizing or partially keratinizing histomorphology, whereas 1 case (12.5%) was predominantly keratinizing. The presence of HR-HPV in 30% of OSSNs and at least 66.7% of LSSCCs suggests the possibility of an etiologic role for HR-HPV at these sites.


Assuntos
Carcinoma in Situ/virologia , Carcinoma de Células Escamosas/virologia , Neoplasias da Túnica Conjuntiva/virologia , Ducto Nasolacrimal/virologia , Infecções por Papillomavirus/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias Oculares/patologia , Neoplasias Oculares/virologia , Feminino , Papillomavirus Humano 16 , Humanos , Imuno-Histoquímica , Hibridização In Situ , Masculino , Pessoa de Meia-Idade , Ducto Nasolacrimal/patologia , Infecções por Papillomavirus/epidemiologia , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/virologia
7.
Infect Control Hosp Epidemiol ; 31(8): 857-9, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20569111

RESUMO

The common cold affects millions of people. Unfortunately, it remains unknown whether cold viruses enter the respiratory tract only through the nose and mouth or whether they can also enter through the tear ducts. Transocular exposure to an airborne infectious dose of human rhinovirus did not lead to infection.


Assuntos
Aerossóis , Microbiologia do Ar , Resfriado Comum/transmissão , Ducto Nasolacrimal/virologia , Rhinovirus/isolamento & purificação , Adulto , Resfriado Comum/virologia , Feminino , Humanos , Masculino , Boca/virologia , Nariz/virologia
8.
Am J Ophthalmol ; 132(6): 922-3, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11730660

RESUMO

PURPOSE: To describe a case of severe dry eye syndrome in a child. METHODS: Observational case report. The authors describe a 10-year-old male with severe dry eyes who was profoundly disabled by pain and photophobia despite aggressive conventional therapy. Lacrimal gland histology was consistent with the primary Sjögren syndrome, and serologic and immunohistologic evidence supported the hypothesis of Epstein-Barr virus causality. RESULTS: Treatment with systemic acyclovir and cyclosporin A resulted in dramatic and rapid reversal of the profound sicca syndrome and enabled the patient to resume his normal activities. CONCLUSION: Epstein-Barr virus dacryoadenitis should be considered in the differential diagnosis of keratoconjunctivitis sicca in children. Epstein-Barr virus can cause keratoconjunctivitis sicca, which can be treated successfully with acyclovir therapy in addition to suppression of the inflammatory response.


Assuntos
Dacriocistite/virologia , Infecções por Vírus Epstein-Barr/virologia , Infecções Oculares Virais/virologia , Ceratoconjuntivite Seca/virologia , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Criança , Ciclosporina/uso terapêutico , Dacriocistite/diagnóstico , Dacriocistite/tratamento farmacológico , Quimioterapia Combinada , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/tratamento farmacológico , Infecções Oculares Virais/diagnóstico , Infecções Oculares Virais/tratamento farmacológico , Glucocorticoides/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Ceratoconjuntivite Seca/diagnóstico , Ceratoconjuntivite Seca/tratamento farmacológico , Masculino , Ducto Nasolacrimal/virologia , Prednisona/uso terapêutico
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