Objective Assessment of Corneal and Lens Clarity in Patients with COVID-19.

SIGNIFICANCE: The severe acute respiratory syndrome coronavirus 2 virus, which causes the coronavirus disease 2019 (COVID-19) pandemic, can bind to epithelial cells in the human cornea and conjunctiva, which may result in changes of corneal and lenticular densitometry. PURPOSE: We aimed to report the corneal and lenticular clarity of patients who had been diagnosed previously with confirmed infection of COVID-19. METHODS: This was a prospective, cross-sectional study. Fifty-three patients who had recovered from COVID-19 and 51 healthy individuals who had not had COVID-19 (control) were included in this study. Measurement of the corneal (at a corneal diameter of 12 mm) and lens densitometry of participants was performed using a Pentacam HR Scheimpflug imaging system. Three different optimal depths as anterior, central, and posterior layers and four concentric zones, consisting of diameters of 0 to 2, 2 to 6, 6 to 10, and 10 to 12 mm, were chosen to perform the corneal densitometric measurements. The mean lenticular densitometric values were calculated in zone 1 at 2.0 mm, zone 2 at 4.0 mm, and zone 3 at 6.0 mm by taking the central part of the pupil as reference point. RESULTS: When compared with the individuals in the control group, the corneal densitometry measurements in the patients in the COVID-19 group were considerably higher in anterior 0 to 2 mm, 2 to 6 mm, 6 to 10 mm zones and total diameter; center 0 to 2 and 2 to 6 mm zones and total diameter; posterior 0 to 2 mm zone; and total corneal 0 to 2 and 2 to 6 mm zones and total diameter (P < .05, for each). When compared with the individuals in the control group, all of the lens densitometry measurements, except for those located in zone 1, were determined to be significantly higher among the patients in the COVID-19 group (P < .05, for each). CONCLUSIONS: Significant alterations were found in corneal and lenticular densitometric values in patients who had had COVID-19. The virus could adversely affect cornea and lens transparency.

The Impact of Coronavirus Disease 2019 (COVID-19) on Retinal Microcirculation in Human Subjects.

BACKGROUND: The aim of the study was to assess retinal microcirculation in patients with coronavirus disease 2019 (COVID-19) through the use of optical coherence tomography angiography (OCT-A) and compare the results with those obtained in healthy controls. METHODS: The study enrolled 39 patients who had fully recovered from COVID-19 and 40 healthy controls. OCT-A image acquisitions were obtained using AngioVue software (version 2017.1.0.151) and the RTVue XR Avanti imaging system (Optovue Inc., Fremont, CA, USA). Nonflow area in the superficial capillary plexus (SCP), foveal avascular zone (FAZ) area in the whole retinal vasculature, FAZ perimeter, acircularity index of FAZ, and foveal density were automatically obtained with the FAZ assessment tool. Vessel density (VD) at the SCP and deep capillary plexus were also measured. RESULTS: Compared to the control group, the nonflow area and the FAZ area in the whole retina was greater in the COVID-19 group; however no statistically significant difference was observed (p > 0.05 respectively). As for vessel densities, all superficial parafoveal VD parameters were considerably higher in the COVID-19 group compared to the control group (p < 0.05 respectively). Despite the fact that the vessel densities in the remaining zones were lower in the COVID-19 group, those differences were not statistically significant (p > 0.05 respectively). CONCLUSION: VD at the parafoveal area of the SCP was significantly higher among patients in the late post-recovery period of COVID-19 disease compared to healthy controls. These findings show the impact of COVID-19 on the retinal microvasculature and its possible role as a risk factor for the development of ocular diseases.

Retinal vascular findings in patients with COVID-19.

PURPOSE: The purpose of this study was to compare the retinal vascular caliber of COVID-19 patients with that of healthy subjects. METHODS: This was a prospective case-control study. Forty-six patients who had COVID-19 were successfully treated, and 38 age- and gender-matched healthy subjects were enrolled in this study. Fundus photography was taken using fundus fluorescein angiography (FA; Visucam 500; Carl Zeiss Meditec, Jena, Germany). Retinal vascular caliber was analyzed with IVAN, a semi-automated retinal vascular analyzer (Nicole J. Ferrier, College of Engineering, Fundus Photography Reading Center, University of Wisconsin, Madison, WI, USA). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery-vein ratio (AVR) were compared between groups. RESULTS: The mean age was 37.8 ± 9.5 years in the COVID-19 group (n = 46) and 40 ± 8 years in the control group (n = 38) (p = 0.45). The mean CRAE was 181.56 ± 6.40 in the COVID-19 group and 171.29 ± 15.06 in the control group (p = 0.006). The mean CRVE was 226.34 ± 23.83 in the COVID-19 group and 210.94 ± 22.22 in the control group (p = 0.044). AVR was 0.81 ± 0.09 in the COVID-19 group and 0.82 ± 0.13 in the control group (p = 0.712). CONCLUSION: Patients who had COVID-19 have vasodilation in the retinal vascular structure after recovery. As they may be at risk of retinal vascular disease, COVID-19 patients must be followed after recovery.

Quantitative assessment of retinal changes in COVID-19 patients.

CLINICAL RELEVANCE: The SARS-COV 2 virus, which is responsible for the COVID-19 pandemic, acts on the angiotensin converting enzyme 2 (ACE-2) receptor in the host cell. Ocular effects may occur because of the ACE-2 receptor in the retina. BACKGROUND: To investigate the impact of COVID-19 on the retinal layers and optic disc parameters in previously confirmed COVID-19 patients using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 60 eyes of 60 subjects; 35 of them were in the COVID-19 group and the remaining 25 were in the control group. Patients with the diagnosis of COVID-19 that had a negative result after treatment were included in the study. Macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements, each retinal layer thickness of all participants were done 14-30 days after COVID-19 symptom onset, following the negative result of real time reverse transcriptase-polymerase chain reaction test using SD-OCT. RESULTS: The mean value of central macular thickness was significantly higher in the COVID-19 group than the control group (p = 0.02). The mean values of the ganglion cell layer and inner nuclear layer thickness in the COVID-19 group were significantly thinner than control group (p = 0.04 and p = 0.04, respectively). Even though mean RNFL thickness measurements in all sections in the COVID-19 group was thinner than controls, there were no significant differences between groups (p > 0.05 for all). CONCLUSION: In the early recovery phase, changes in the macula, ganglion cell layer and inner nuclear layer could be seen. These patients should be followed up closely for the recognition of new pathologies that could be seen in the late recovery phase.

Endometriosis within the inguinal hernia sac.

Endometriosis is characterized by the presence of histologically normal endometrial tissue outside the uterine cavity. Endometriotic implants are usually located in the pelvic organs, but they have been described in almost every location of the female body. It may also be present after cesarean section or other gynecological operations. In this study, we reported a rare case of endometriosis located in an indirect inguinal hernia sac.

Ectopic Adrenal Gland Tissue In The Inguinal Hernia Sac Occuring In An Adult.

Ectopic adrenal tissue is a benign lesion generally determined incidentally during a surgical intervention applied for another reason. This tissue may be present along the path of the testicles and groin discovered during surgery. While the condition has been mainly reported in the pediatric population, it is very rarely reported in adults. The aim of this study was to present an adult patient with ectopic adrenal tissue which was determined incidentally within an indirect inguinal hernia sac.

Foreign body in the stomach: Dentures.

Although it is mostly observed in childhood, swallowing foreign bodies causes morbidity and mortality of a high percentage in the adult age group. Swallowed foreign bodies can be both harmless as well as life-threatening. The number, shape, size, and time of the swallowed foreign body to get deposited in the specific location determines the type of treatment. Late diagnosis and treatment is an important problem that causes perforation and obstruction. In this article, we presented a 39-year-old male patient who swallowed his denture while sleeping.

A giant ancient schwannoma mimicking an adnexal mass: Case report.

INTRODUCTION: Ancient schwannoma is a rare tumor of the peripheral nerve sheath. As degenerative properties are defined histologically, it can be wrongly interpreted as malignant. CASE PRESENTATION: The case presented here is of a giant ancient schwannoma with a pelvic retroperitoneal location, which was mimicking an adnexal mass. CONCLUSION: In the rarely seen cases in the retroperitoneum, it may reach very large dimensions.

Factors Affecting Morbidity in Solid Organ Injuries.

Background and Aim. The aim of this study was to investigate the effects of demographic characteristics, biochemical parameters, amount of blood transfusion, and trauma scores on morbidity in patients with solid organ injury following trauma. Material and Method. One hundred nine patients with solid organ injury due to abdominal trauma during January 2005 and October 2015 were examined retrospectively in the General Surgery Department of Dicle University Medical Faculty. Patients' age, gender, trauma interval time, vital status (heart rate, arterial tension, and respiratory rate), hematocrit (HCT) value, serum area aminotransferase (ALT) and aspartate aminotransferase (AST) values, presence of free abdominal fluid in USG, trauma mechanism, extra-abdominal system injuries, injured solid organs and their number, degree of injury in abdominal CT, number of blood transfusions, duration of hospital stay, time of operation (for those undergoing operation), trauma scores (ISS, RTS, Glasgow coma scale, and TRISS), and causes of morbidity and mortality were examined. In posttraumatic follow-up period, intra-abdominal hematoma infection, emboli, catheter infection, and deep vein thrombosis were monitored as factors of morbidity. Results. One hundred nine patients were followed up and treated due to isolated solid organ injury following abdominal trauma. There were 81 males (74.3%) and 28 females (25.7%), and the mean age was 37.6 ± 18.28 (15-78) years. When examining the mechanism of abdominal trauma in patients, the following results were obtained: 58 (53.3%) traffic accidents (22 out-vehicle and 36 in-vehicle), 27 (24.7%) falling from a height, 14 (12.9%) assaults, 5 (4.5%) sharp object injuries, and 5 (4.5%) gunshot injuries. When evaluating 69 liver injuries scaled by CT the following was detected: 14 (20.3%) of grade I, 32 (46.4%) of grade II, 22 (31.8%) of grade III, and 1 (1.5%) of grade IV. In 63 spleen injuries scaled by CT the following was present: grade I in 21 (33.3%), grade II in 27 (42.9%), grade III in 11 (17.5%), and grade IV in 4 (6.3%). The mean length of hospital stay after trauma was 6.46 days in the medically followed patients. This ratio was 8.13 days in 22 patients with morbidity and 5.98 days in 78 patients without morbidity. There was a morbidity in 22 (22%) patients medically followed after trauma. In this study, nonoperative treatment was observed to be performed safely in solid organ injuries after trauma in case of absence of hemodynamic stability and peritoneal irritation. It has been emphasized that injury of both liver and spleen (p < 0.01), high respiratory rate (p < 0.01), trauma scores (GKS, ISS, RTS) (p < 0.0001), and elevation of ALT AST values (p < 0.01) are stimulants for morbidity that may occur during follow-up. Conclusion. Medical follow-up can be considered in patients with high grade injuries similar to patients with low-grade solid organ injury after trauma. The injury of both liver and spleen, high respiratory rate, high GCS and ISS, low RTS, and elevation of ALT AST values were found to increase morbidity again in the follow-up of these patients.

A Urachal Cyst Case with Painful Mass Locates at Ileal Mesentery.

Urachal cyst is an unusual clinical condition, which is usually asymptomatic. In some adult cases, it may lead to complications. The cyst is between umbilicus and urinary bladder. It is diagnosed via ultrasonography and computed tomography. However, in some cases, the diagnosis is made by means of surgical exploration and histopathological evaluation. In this paper, we report a case of a 17-year-old female presenting with painful abdominal mass. At the first evaluation, the case was diagnosed as a mesenteric cyst because the mass located in the mesentery, and final histopathological report revealed the urachal cyst.