冠状病毒感染于2019年底在中国武汉开始,并在世界各地迅速传播。产生Covid19大流行。Covid病的表现千差万别,从简单的流感,发烧,咳嗽,弱点,头痛,关节痛,严重的肺炎,严重急性呼吸系统综合症(SARS-Cov2)甚至死亡。这种疾病的症状,进化和出现的并发症各不相同,根据相关病理-糖尿病(DM),高血压(HT),患者的年龄和免疫状态。目的:与Covid19相关的眼部表现主要以结膜炎为代表,但是冠状病毒的嗜神经特性可以证明某些神经眼科表现的出现是合理的,如:视神经炎(ON),颅神经麻痹,视野(VF)异常。本文的目的是研究2020年至2022年期间发表在专业文献中的Covid19后视神经病变病例。评估了以下内容:风险因素,按年龄组和性别分布,进化和并发症,以及视神经病变的临床形式。材料和方法:我们使用GoogleScholar和PubMed数据库查找与Covid-19感染相关的视神经病变的文章。我们跟踪了大流行期间发表的文章,选择了21例病例,共有17位作者,不管他们的起源和他们写的语言。结果:Covid-19疾病中21例受ON影响的患者,11个女人和10个男人,被提及。作者描述的视神经病变是:球后视神经病变,只有一个与髓鞘少突胶质细胞糖蛋白(MOG)相关,乳头炎,神经视网膜炎,前部缺血性视神经病变(AION),其中一个动脉炎性前部缺血性视神经病变(AAION)和其他非动脉炎性前部缺血性视神经病变(NAAION),一个与急性呼吸窘迫综合征(ARDS)的经口气管插管(OTI)患者的内旋有关。讨论:与Covid19疾病相关的神经眼科并发症可能很严重,所以应该持续监测病人。许多调查(血清学,免疫学和影像学检查)对于排除ON的其他病因是必要的。结论:每位被诊断患有Covid19疾病的患者都必须进行完整的眼科检查,即使他们有眼部表现或没有。缩写:SARS-Cov2=严重急性呼吸综合征;DM=糖尿病;HT=高血压;ON=视神经炎;VF=视野;NS=神经系统;CRP=C-反应蛋白;CL=细胞因子;IL=白细胞介素;TNFα=肿瘤坏死因子;CNS=中枢神经系统;CNS=中枢神经系统
The Corona virus infection started at the end of 2019 in Wuhan - China and spread rapidly throughout the world, generating the Covid 19 pandemic. The manifestations of the Covid disease were extremely varied, from a simple flu, with fever, cough, weakness, headache, joint pain, up to severe pneumonia, with severe acute respiratory syndrome (SARS-Cov2) and even death. The symptomatology of the disease, the evolution and the complications that appeared varied, depending on the associated pathology - diabetes mellitus (DM), hypertension (HT), the age and the immune status of the patient. Aim: The ocular manifestations related to Covid 19 were mostly represented by conjunctivitis, but the neurotropic character of Corona virus could justify the appearance of certain neuro-ophthalmological manifestations, such as: optic neuritis (ON), cranial nerve palsies, visual field (VF) anomalies. The aim of this paper was to research the cases of optic neuropathy post-Covid 19, published in the specialty literature between 2020 and 2022. The following were evaluated: risk factors, distribution by age group and gender, evolution and complications, as well as the clinical forms of optic neuropathies. Materials and methods: We used Google Scholar and PubMed databases to find articles on optic neuropathies related to the Covid-19 infection. We followed the articles published during the pandemic and selected 21 cases, belonging to 17 authors, irrespective of their origin and the language in which they were written. Results: 21 patients affected by ON in the Covid-19 disease, 11 women and 10 men, were mentioned. The optic neuropathies described by the authors were: retrobulbar optic neuropathy, only one associated with myelin oligodendrocyte glycoprotein (MOG), papillitis, neuroretinitis, anterior ischemic optic neuropathy (AION), out of which one arteritic anterior ischemic optic neuropathy (AAION) and the others non-arteritic anterior ischemic optic neuropathy (NAAION), one being related to pronation in an oro-tracheal intubated (OTI) patient with acute respiratory distress syndrome (ARDS). Discussions: The neuro-ophthalmological complications associated with Covid 19 disease can be severe, so the patients should be monitored continuously. Many investigations (serological, immunological and imaging exams) are necessary to exclude other etiologies of ON. Conclusions: A complete ophthalmological exam is mandatory for each patient diagnosed with Covid 19 disease, even if they have ocular manifestations or not. Abbreviations: SARS-Cov2 = severe acute respiratory syndrome; DM = Diabetes mellitus; HT = Hypertension; ON = Optic neuritis; VF = Visual field ; NS = Nervous system; CRP = C-reactive Protein; CL = cytokines; IL = interleukins; TNFɑ = tumor necrosis factor; CNS = central nervous system; ACE = angiotensin-converting enzyme; CRVO = central retinal vein occlusion; MOG = myelin oligodendrocyte glycoprotein; MOG-AD = myelin oligodendrocyte glycoprotein antibody disease; BBB = blood-brain barrier; ARDS = acute respiratory distress syndrome; IOP = intraocular pressure; CVP = central venous pressure; MSOF = multiple systems organ failure; AAION = arteritic anterior ischemic optic neuropathy; NAION = non-arteritic anterior ischemic optic neuropathy; AION = anterior ischemic optic neuropathy; OCT = optical coherence tomography; CT = computer tomography; AFG = angiofluorography; MRI = magnetic resonance imaging; ESR = erythrocyte sedimentation rate; RF = rheumatoid factor; ANA = antinuclear antibodies; ANCA = antineutrophil cytoplasmic antibodies; AQP4 = anti aquaporin 4; NMO = neuromyelitis optica; CSF = cerebrospinal fluid; OTI = oro-tracheal intubated; VA = visual acuity; ONTT = optic neuritis treatment trial; RNFL = retinal nerve fiber layer; ICU = intensive care unit; LE = left eye; RE = right eye; MS = multiple sclerosis; ICH = intracranial hypertension; BCVA = best correction visual acuity; LP = light perception; APD = afferent pupillary defect; BM = biomicroscopy; PDN = prednisone; MTX = methotrexate; MTPN = methylprednisolone; NSAID = non-steroidal anti-inflammatory drugs; CGL = cells ganglion layer; VEP = visual evoked potential; CF = counting fingers.