■这项研究的目的是证明原发性急性闭角(APAC)和COVID-19感染的相关性,比较APAC患者COVID-19阳性和阴性的人口学特征和表现,并推断潜在的机制。
■这项研究是基于在眼青光眼中心诊断为APAC的所有患者,耳朵,复旦大学附属鼻喉部医院(汾阳路中心)2022年12月15日至2023年1月11日。171例APAC病例分为COVID-19阳性和阴性组。比较两组患者的人口学特征和最终治疗水平。临床表现,眼内压,并比较两组的前房构型。
■在COVID-19阳性组中,2022年12月22日,APAC发病的病例数量激增,这与COVID-19抗原阳性人群的高峰相吻合。与COVID-19阴性组相比,COVID-19阳性的APAC患者年轻,APAC病史百分比较低。此外,更多的COVID-19阳性APAC患者的眼睛显示角膜沉淀。COVID-19阳性眼的前房深度明显更大,瞳孔扩大。因此,COVID-19感染可能是APAC的触发因素。
■对于年龄较小、解剖结构较温和的患者,COVID-19感染可能会加速APAC的发作。此外,与COVID-19相关的APAC病例可能有更突然和更激烈的发作。在流行期间,眼科紧急服务不应被忽视。
The aim of this study is to demonstrate the relevance of primary acute angle closure (APAC) and COVID-19 infection, compare the demographic features and manifestations between COVID-19 positive and negative patients with APAC, and infer the underlying mechanism.
This study is based on all patients diagnosed with APAC at the glaucoma center of Eye, Ear, Nose and Throat Hospital of Fudan University (Fenyang road center) from 15th December 2022 to 11th January 2023. Totally 171 APAC cases were categorized into COVID-19 positive and negative group. Demographic features and final treatment level of the patients were compared between the two groups. Clinical manifestations, intraocular pressure, and anterior chamber configuration were also compared between the two groups.
In the COVID-19 positive group, the number of cases with APAC onset spiked in 22nd December 2022, which coincided with the spike of COVID-19 antigen positive people. Compared to the COVID-19 negative group, COVID-19 positive APAC patients were younger with a lower percentage of APAC history. Additionally, more eyes of COVID-19 positive APAC patients showed keratic precipitates. COVID-19 positive eyes had significantly larger anterior chamber depth with a more dilated pupil. Therefore, COVID-19 infection could probably act as a triggering factor of APAC.
The onset of APAC might be accelerated by COVID-19 infection for patients with younger age and milder anatomical configuration. Additionally, COVID-19 related APAC cases might have a more abrupt and fierce onset. Ophthalmic emergent services should not be neglected during the epidemic period.