An Insidious Clinical Picture: Optic Nerve Involvement in Patients with COVID-19
Özgül Ocak1
, Erkan Melih Şahin2, Alper Şener3, Barış Ocak4
1Canakkale Onsekiz Mart University Faculty of Medicine, Department of Neurology, Canakkale, Turkey
2Canakkale Onsekiz Mart University Faculty of Medicine, Department of Family Medicine, Canakkale, Turkey
3Izmir Katip Celebi University Faculty of Medicine, Department of Infectious Disease, Izmir, Turkey
4Canakkale State Hospital, Clinic of Ophthalmology, Canakkale, Turkey
Keywords: COVID-19 virus infection, optic nerve, VEP
Abstract
Objective: Many neurological symptoms due to central nervous system, peripheral nervous system and musculoskeletal system damage have been reported in more than a third of patients with coronavirus disease-2019 (COVID-19). Although optic neuritis has been reported in patients with COVID-19, they are extremely rare. The aim of this study was screening optic nerve involvement in COVID-19 with visual evoked potential (VEP) in asymptomatic patients without a history of visual impairment.
Materials and Methods: Pattern reversal VEP measurements were made in 101 adult patients with COVID-19 without a history of visual impairment after they completed COVID-19 treatments and the quarantine period. VEPs were recorded with the 4-channel electromyography-evoked device in a dark room. P100 latencies and amplitudes were analyzed by the same neurologist.
Results: A total of 34 (33.7%) patients had P100 latency prolongation. There was no significant difference in terms of gender, age or outpatient/inpatient treatment status. There was no significant correlation between the time of polymerase chain reaction diagnosis and VEP values.
Conclusion: Contrary to previous studies, asymptomatic optic nerve involvement after COVID-19 was detected by VEP measurements. Prolongation of P100 latency shows the probable linkage between COVID-19 virus and angiotensin converting enzyme 2 receptors in human eyes.
Canakkale Onsekiz Mart University Faculty of Medicine Institutional Ethics Committee approval was obtained for the study (project no: 2011-KAEK27/2020-E.2000183492, approval no: 2020-14).
Informed consent from all participants was obtained.
Externally peer-reviewed.
Surgical and Medical Practices: Ö.O., B.O., Concept: Ö.O., E.M.Ş., A.Ş., Design: Ö.O., E.M.Ş., A.Ş., Data Collection or Processing: Ö.O., E.M.Ş., B.O., Analysis or Interpretation: Ö.O., E.M.Ş., A.Ş., B.O., Literature Search: Ö.O., A.Ş., Writing: Ö.O., E.M.Ş., A.Ş., B.O.
No conflict of interest was declared by the authors.
The authors declared that this study received no financial support.