Detection of SARS-CoV-2 RNA in a conjunctival swab sample in real-time-polymerase chain reaction positive COVID-19 patients and its association with comorbidity and severity at a designated COVID-19 hospital in Central India.

PURPOSE: To evaluate the presence of SARS-CoV-2 RNA in the conjunctival swab sample of positive confirmed COVID-19 patients and to find out its association with comorbidity and severity of COVID-19 disease. METHODS: We conducted an observational cross-sectional study at a dedicated tertiary COVID-19 hospital in central India for a period of 8 weeks from February 2021to March 2021. We included patients who tested positive for SARS-CoV-2 RNA through nasopharyngeal swab and were above 18 years of age. Swab samples have been collected within 48 h of admission. Conjunctival swab was taken from the lower fornix of both eyes and sent to microbiology laboratory for real-time- polymerase chain reaction (RT-PCR). RESULTS: Out of 150 patients, conjunctival swab RT-PCR was positive in five patients (3.33%). Two patients had conjunctival manifestations in the form of conjunctivitis but conjunctival swab RT-PCR was negative in those patients. Among the RT-PCR positive patients, two (40%) were from mild, one (20%) was from moderate, and two (40%) were from severe category. No association could be established between conjunctival swab RT-PCR positivity and severity of the disease or associated comorbidity. CONCLUSION: Our study provides evidence that SARS-CoV-2 RNA could be detected in conjunctival secretions, and though the risk is relatively low, the eye may act as source of transmission. Extra caution should be taken by healthcare workers, and use of proper precautions like face shields and goggles should be encouraged.

Intravitreal bevacizumab (avastin) in a pediatric case of pathologic myopia.

PURPOSE: To report the successful consecutive use of intravitreal bevacizumab (Avastin) in a child with myopic choroidal neovascular membrane (mCNVM). METHOD: A 12-year-old child presented with gradual diminution of vision in both eyes. Ocular examination revealed pathologic myopia with mCNVMs in both eyes. Leakage was demonstrated on fluorescein angiography in right eye at the first visit, followed by the left eye 1 week later. A single injection of bevacizumab (Avastin) 1.25 mg (0.05 mL) was administered under aseptic precautions using a 30-G needle in each eye separated by duration of 1 week. There were no complications during or after each procedure RESULTS: : Leakage from the mCNVM was reduced in both eyes within 2 weeks after the injections and there was reduction of macular thickness in both eyes. However, visual acuity change was modest, with the right eye improving from Snellen acuity of 1/60 before injection to 6/60 and the left eye remaining stable at 3/60. CONCLUSION: Intravitreal Avastin was safely injected successively in each eye in a pediatric case of pathologic myopia with mCNVM. Reduction of leakage and macular thickening may not be associated with commensurate visual improvement as in our case. Long-term safety and appropriate dosage of intravitreal bevacizumab needs to be studied before routine use in pediatric cases of neovascularization.