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  • SARS-CoV-2 Viral Particles in the Human Retina

    By Jean Shaw
    Selected and Reviewed by Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, September 2021

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    Araujo-Silva et al. set out to determine whether particles of the SARS-CoV-2 virus and its characteristic proteins could be detected in the enucleated eyes of patients affected by COVID-19. They found presumed viral particles in several retinal layers, suggesting that the particles may be involved in some of the infection’s ocular manifestations.

    For this study, the researchers analyzed the retinas of three patients who died of COVID (age range, 69-78 years). All three had been in the intensive care unit before their deaths. Samples from their enucleated eyes underwent immunofluorescence and transmission electron microscopy processing.

    Via immunofluorescence microsco­py, the virus’ S and N proteins could be seen in various regions of the retina, including the ganglion cell layer, inner and outer plexiform layers, and outer nuclear layer, as well as in the retinal pigment epithelium and the choroid. These findings are in close agreement with previous findings of the SARS-CoV-2 S1 protein in the neurosensory retina, the authors said.

    Transmission electron microscopy scanning of thin sections showed the presence of presumed viral particles. These double-membrane vacuoles were located in the perinuclear region of ret­inal cells, including those of the inner and outer nuclear layers.

    Further research is needed, the authors said, including investigations into whether these retinal changes are related to secondary microvascular and immunological changes, represent the direct presence of the virus, or signify a combination of these and other factors. (Also see related commentary by Nasreen A. Syed, MD, and Charles Grose, MD, in the same issue.)

    The original article can be found here.