Dear Editor,
We sincerely thank Srinivasan et al.[1] for their interest in our work.[2] In our study, we evaluated the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA on real-time polymerase chain reaction (RT-PCR) in the aqueous and vitreous samples of nasopharyngeal swab-positive coronavirus disease 2019 (COVID-19) patients undergoing emergency intraocular surgeries, and our article was submitted to the Indian Journal of Ophthalmology (IJO) on 11 April 2021. Koo et al.[3] demonstrated the presence of SARS-CoV-2 RNA on RT-PCR in the aqueous sample of patients undergoing elective anterior segment surgery. These patients had no symptoms of COVID-19, and their nasal swab was negative for SARS-CoV-2.[3] This paper was published online on 19 May 2021 (after we submitted the paper to IJO). However, in an article by Bilgic et al.[4] which was published online on 9 March 2021, the presence of SARS-CoV-2 was noted in the vitreous sample of a patient with endophthalmitis using RT-PCR. Thus, we agree that the statement “To the best of our knowledge, no study to date evaluated the intraocular fluids for the presence of SARS-CoV-2 in live humans” does not hold true and we thank the authors[1] to bring this to our knowledge.
Inflammatory markers (D-dimer and serum ferritin) were raised in two of our patients who had symptomatic COVID. However, in our cohort of patients, we did not analyze SARS-CoV-2 antibodies.
We agree with the authors’ interpretation that SARS-CoV-2 RNA is either not detected or detected in a very low percentage in the ocular samples of COVID-19 patients, which is supported by our study as well.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1. Srinivasan S, Ramana AV, Padmamalini M, Ankush K, Rohit S. Severe acute respiratory syndrome Corona virus and intraocular fluid sampling. Indian J Ophthalmol. 2021;69:3791. doi: 10.4103/ijo.IJO_2298_21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Hada M, Khilnani K, Vyas N, Chouhan JK, Dharawat KS, Bhandari S, et al. Evaluating the presence of SARS-CoV-2 in the intraocular fluid of COVID-19 patients. Indian J Ophthalmol. 2021;69:2503–6. doi: 10.4103/ijo.IJO_820_21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Koo EH, Eghrari AO, Dzhaber D, Shah A, Fout E, Dubovy S, et al. Presence of SARS-CoV-2 viral RNA in aqueous humor of asymptomatic individuals. Am J Ophthalmol. 2021;230:151–5. doi: 10.1016/j.ajo.2021.05.008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Bilgic A, Sudhalkar A, Gonzalez-Cortes JH, March de Ribot F, Yogi R, Kodjikian L, et al. Endogenous endophthalmitis in the setting of covid-19 infection: A case series. Retina Phila Pa. 2021;41:1709–14. doi: 10.1097/IAE.0000000000003168. [DOI] [PubMed] [Google Scholar]