Joob Beuy1, Won Sriwijitalai2

1Sanitation 1 Medical Academic Center, Bangkok, Thailand
2Department of Pharmaceutical Sciences, University Centre for Research & Development Chandigarh University Gharuan, Mohali, Punjab, India

We would like to share ideas on the publication “An Insidious Clinical Picture: Optic Nerve Involvement in Patients with COVID-19.”[1] Contrary to earlier research, asymptomatic optic nerve involvement following COVID-19 (coronavirus disease 2019) was found by visual evoked potential (VEP) measurements, according to Ocak et al.[1] In their study, Ocak et al.[1] came to the conclusion that an increase in P100 latency indicated a possible connection between the COVID-19 virus and the angiotensin-converting enzyme 2 (ACE2) receptors in human eyes. We concur that SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) may impact the cranial nerve and cause a number of neurological issues, including hearing loss.[2] However, it is important to understand the impact of any confounding factors that can contribute to an optic nerve issue in a COVID-19 patient. It is difficult to draw conclusions about the correlation without information about pre-COVID-19 health/optic history. Finally, ACE2 receptors may be important, as shown by Ocak et al.[1] Patients with COVID-19 may experience pathophysiological changes as a result of genetic variations in the ACE2 gene.[3] The impact of the polymorphism has to be acknowledged and further investigated.

Cite this article as: Beuy J, Sriwijitalai W. An insidious clinical picture: Optic nerve involvement in patients with COVID-19. Turk J Neurol 2024;30(2):120. doi: 10.4274/tnd.2023.30837.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Author Contributions

All authors contributed equally to the article.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.


  1. Ocak Ö, Şahin EM, Şener A, Ocak B. An insidious clinical picture: Optic nerve involvement in patients with COVID-19. Turk J Neurol 2022;28:158-61.
  2. Sriwijitalai W, Wiwanitkit V. Hearing loss and COVID19: A note. Am J Otolaryngol 2020;41:102473. doi: 10.1016/j.amjoto.2020.102473.
  3. Ma Y, Li Q, Chen J, Liu S, Liu S, He X, et al. Angiotensin-converting enzyme 2 SNPs as common genetic loci and optimal early ıdentification genetic markers for COVID-19. Pathogens 2022;11:947. doi: 10.3390/pathogens11080947.