Central Retinal Artery Occlusion in COVID-Associated Mucormycosis.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-04-01 DOI:10.4103/jgid.jgid_185_22

Smiti Rani Srivastava, Peyalee Sarkar, Purban Ganguly, Debaleena Mukherjee, Biman Kanti Ray, Souvik Dubey, Alak Pandit, Amitabh Sengupta, Manimoy Bandopadhyay, Asim Kumar Ghosh, Kanika Gupta Poddar, Soumyajit Guha, Asif Ayub

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Abstract

Introduction: Significant surge of mucormycosis was reported in the Indian Subcontinent during the second wave of the COVID-19 pandemic. COVID-associated mucormycosis (CAM) was defined as the development of features of mucormycosis with prior or current history of COVID-19 infection. Rapid angioinvasion is an important characteristic of mucormycosis. Authors intended to find out the prevalence of retinal arterial occlusion and its association with vascular embolic occlusion elsewhere in the body among CAM patients in this study.

Methods: This was an observational study. All consecutive-confirmed cases of mucormycosis (n = 89) and age-/gender-/risk factor-matched controls (n = 324) admitted in the designated COVID center were included in the study. All cases and controls underwent comprehensive ophthalmological, otorhinological, and neurological examinations. All necessary investigations to support the clinical diagnosis were done. Qualitative data were analyzed using the Chi-square test. Quantitative data for comparison of means between the cases and controls were done using unpaired t-test.

Results: Twenty-one (23.59%) patients manifested the defined outcome of central retinal artery occlusion (CRAO). Among age-matched control, with similar diabetic status, none had developed the final outcome as defined (P < 0.05). About 90.47% of subjects with CRAO presented with no perception of light vision. Thirteen subjects (61.9%) with the final outcome developed clinical manifestations of stroke during the course of their illness with radiological evidence of watershed infarction (P = 0.001). Orbital debridement was performed in 9 (42.85%) subjects while orbital exenteration was done in 8 (38.09%) subjects.

Conclusions: CRAO in CAM patients was found to have aggressive nature turning the eye blind in a very short period of time. CRAO can serve as a harbinger for subsequent development of more debilitating and life-threatening conditions such as stroke among CAM patients.

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冠状病毒相关毛霉菌病的视网膜中央动脉闭塞。

导言:据报告，在2019冠状病毒病第二波大流行期间，印度次大陆毛霉病病例大幅增加。COVID-19相关毛霉菌病(CAM)定义为既往或当前有COVID-19感染史的毛霉菌病特征的发展。快速血管浸润是毛霉病的一个重要特征。作者希望在本研究中了解CAM患者视网膜动脉闭塞的患病率及其与身体其他部位血管栓塞的关系。方法:观察性研究。所有在指定的COVID中心连续确诊的毛霉菌病病例(n = 89)和年龄/性别/危险因素匹配的对照组(n = 324)被纳入研究。所有病例和对照组均进行了全面的眼科、耳鼻喉学和神经学检查。所有支持临床诊断的必要调查均已完成。定性资料采用卡方检验进行分析。病例与对照间均值比较的定量数据采用非配对t检验。结果:21例(23.59%)患者表现为视网膜中央动脉闭塞(CRAO)。在年龄匹配、糖尿病状况相似的对照组中，没有出现定义的最终结局(P < 0.05)。约90.47%的CRAO患者表现为光视觉无知觉。13例(61.9%)患者在发病过程中出现脑卒中临床表现，影像学证据为分水岭梗死(P = 0.001)。9例(42.85%)患者行眼眶清创，8例(38.09%)患者行眼眶清创术。结论:CAM患者的CRAO具有侵袭性，可在极短的时间内致眼盲。CRAO可以作为CAM患者中风等更加衰弱和危及生命的疾病后续发展的先兆。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.