CHANDIGARH: The first-ever national registry study on non-infectious uveitis-NIU (inflammation of the middle layer of the eye) concludes that the patients who stop medicine abruptly due to the fear of Covid-19 are at a higher risk of vision loss.
Uveitis is a manifestation of several systemic inflammatory conditions, with a high risk of severe Covid-19. The patients are on immunomodulatory drugs, biological therapies, and/or corticosteroids, which are expected to increase the risk of severe respiratory infection. However, in their study published in the British Journal of Ophthalmology, doctors Aniruddha Agarwal, Rupesh Agrawal, Vishali Gupta, and Manisha Agarwal from the PGI's Advanced Eye Centre infer that a sudden reduction in dosages can have undesirable recurrences. “Basically it implies that these patients are at a higher risk of vision loss, if they stop taking medicine due to the fear of Covid,” said Dr Aniruddha.
The study mentions the current dilemma in the use of high-dose oral corticosteroids during the Covid-19 pandemic, with fears of increased susceptibility to severe respiratory infection. On the other hand, in the later course of the disease when the patients require oxygen support or mechanical ventilation, corticosteroids may save them from inflammatory response, though large trials have variable mortality rates.
Subjects receiving the class NIU-class drugs were analysed from March to June. The 176 patients (284 eyes) visited major tertiary-care eye hospitals. Of the tested eyes, 121 had active uveitis, while 163 had inactive NIU. Also, 32% of the eyes (29 subjects) developed a relapse, of which 86.2% (25 subjects) developed active uveitis due to modification in the medicine (either reduced dosage by doctors or self stopping."
The signs of uveitis may include blurred or cloudy vision, eye pain, redness, floaters, and spots in the eye that look like tiny rods or chains of transparent bubbles floating around in the field of vision.