■为了调查COVID-19后脉络膜视网膜病变的发生,强调人口统计学特征,用药史,临床表现,诊断评估,和治疗方法,特别关注皮质类固醇的作用。
■我们的方案在PROSPERO(CRD42023457712)上进行了前瞻性注册。对数据库的系统搜索(PubMed,科克伦,WOS,Scopus)于2020年11月至2023年8月进行,以确定任何报告COVID-19患者脉络膜视网膜病变的原始研究。数据提取包括患者人口统计,COVID-19时间表,用药史,症状,诊断测试,和治疗结果。我们使用JoannaBriggs研究所(JBI)的关键评估工具来评估我们纳入研究的质量。
■我们确定了7例病例报告和2例病例系列,包括10例患者,六名女性和四名男性(平均年龄36.5岁),COVID-19后出现脉络膜视网膜病变。发病从感染后6天到3个月不等(平均=24.3天)。7例患者(70%)在COVID-19治疗期间有皮质类固醇使用史。症状包括视力丧失,视力模糊,和恶化。诊断评估显示,7例患者(70%)为中心性浆液性脉络膜视网膜病变,2例(20%)为点状内部脉络膜病变。治疗方法多种多样,皮质类固醇停药导致症状改善,而两名患者接受皮质类固醇治疗。据报道,5例停用皮质类固醇的患者视力有所改善,其中2例20/40后变为20/25,2例变为6/6,1例变为20/20,而第6例患者的视力未报告.关于两名接受皮质类固醇治疗的患者,仅1例报告视力,改善至20/20。
■本系统综述阐述了脉络膜视网膜病变的患病率和潜在关联,在COVID-19的背景下使用皮质类固醇。这种关系仍不清楚,因为在某些情况下,皮质类固醇停药后症状缓解,而另外两例患者接受糖皮质激素治疗,症状改善。
UNASSIGNED: To investigate the occurrence of chorioretinopathy post-COVID-19, emphasizing demographic characteristics, medication history, clinical presentation, diagnostic evaluation, and treatment approaches, with a specific focus on the role of corticosteroid use.
UNASSIGNED: Our protocol was registered prospectively on PROSPERO (CRD42023457712). A systematic search of databases (PubMed, Cochrane, WOS, Scopus) from November 2020 to August 2023 were performed to identify any original research reporting chorioretinopathy in COVID-19 patients. Data extraction included patient demographics, COVID-19 timeline, medication history, symptoms, diagnostic tests, and treatment outcomes. We used Joanna Briggs Institute (JBI) critical appraisal tool to assess the quality of our included studies.
UNASSIGNED: We identified seven case reports and two case series including 10 patients, six females and four males (mean age 36.5 years), who exhibited chorioretinopathy after COVID-19. Onset varied from 6 days to three months post-infection (average = 24.3 days). Seven patients (70%) had a history of corticosteroid use during COVID-19 treatment. Symptoms included visual loss, blurred vision, and deterioration. Diagnostic assessments revealed central serous chorioretinopathy in seven patients (70%) and punctate inner choroidopathy in two (20%). Treatment approaches varied, with corticosteroid discontinuation leading to symptom improvement, while two patients were treated with corticosteroids. Five patients who discontinued corticosteroids were reported to have improvement in visual acuity, two of them changed to 20/25 after being 20/40, two changed to 6/6, and one changed to 20/20, while the visual acuity in the sixth patient was not reported. Regarding the two patients who were treated with corticosteroids, visual acuity was reported in one case only and it improved to 20/20.
UNASSIGNED: This systematic review states the prevalence and potential association between chorioretinopathy, and corticosteroid use in the context of COVID-19. This relation is still unclear because of the relief of symptoms in some cases after corticosteroid discontinuation, while two other cases were treated with corticosteroids and their symptoms improved.