由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的新型冠状病毒感染(COVID-19)在全球持续大流行,给全球医疗模式带来了深刻影响,更多积累的、新的医学资料提示SARS-CoV-2感染会侵犯患者多个器官,但对其引起的眼部相关病变特征及其危害仍缺乏足够认识。已有的临床资料发现,COVID-19相关眼病主要包括眼表炎性病变和眼后节的视网膜、脉络膜病变,疾病不仅表现为急性炎性反应过程,还可导致视网膜和脉络膜的微血管栓塞性病理过程,给患者,尤其是首诊为眼科的患者视力预后可能带来长期影响,准确诊断COVID-19相关眼病是眼科医生面临的挑战。眼科医生应深入了解SARS-CoV-2感染者眼病相关疾病的发生机制和发展规律,利用目前的眼科多模式影像检查以减少患者相关眼部疾病的漏诊和误诊,及时采取针对性治疗措施,尽可能降低疾病对视功能损害的风险。建议眼科临床工作者开展相关疾病的发病机制研究及多学科临床研究,以降低COVID-19相关眼病患者的致盲率,改善患者的生活质量。
The continuous pandemic coronavirus disease 2019 (COVID-19) in the world has had a profound impact on the global medical model.More accumulated new medical data suggest that severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection will invade multiple organs of patients, but there is still a lack of sufficient understanding of the characteristics of ocular related lesions and their prognosis.The existing clinical data found that COVID-19-related ocular diseases mainly include ocular surface inflammatory lesions and retinopathy and choroidopathy in the posterior segment.The disease is not only an acute inflammatory reaction process, but also can lead to the pathological process of microvascular thrombosis in the retina and choroid, which may have a long-term impact on the visual prognosis of patients, especially those who were initially diagnosed as ophthalmic manifestations.Accurate diagnosis of COVID-19-related ocular diseases is a challenge for ophthalmologists.Ophthalmologists should have a deep understanding of the pathogenesis and development of SARS CoV-2 infected eyes, make use of the current multimodal ophthalmic imaging examination to reduce misdiagnosis and take timely targeted treatment measures to minimize the risk of disease damage to visual function.We suggest that clinical ophthalmologists pay attention to carry out the pathogenesis research of related diseases and multidisciplinary clinical research to reduce the blindness rate of patients with SARS CoV-2 infection and improve patients' quality of life.
魏文斌,周楠. 充分认识COVID-19相关眼部损害,努力提高诊疗水平[J]. 中华实验眼科杂志,2023,41(02):104-109.
DOI:10.3760/cma.j.cn115989-20230103-00004版权归中华医学会所有。
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