Ocular Ischemic Events and Vision Loss Associated with COVID-19 Acute Hypoxic Respiratory Failure
, Tolulope Fashina 2,†, Casey Randleman 3, William Pearce 4, Jill Wells 5, Steven Yeh 2,6,7,* and Jessica G. Shantha 8,*Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsDear authors,
These are very interesting cases. Thank you for your detailed report. Could you get a little more into the problem that a definitve cause of the occlusions by COVID cannot be proved? Theoretically, there could be other reasons and the COVID infection a mere coincidence.
The main question is the presentation of 2 COVID-associated retinal occlusion cases. The 2 cases are interesting, but they do not fill any specific scientific gap. As far as I know, the paper does not add new information to the known literature. As these are mere case presentations, the main problem (is it really caused by COVID or just a coincidence) cannot be covered. The conclusions are consistent with the evidence, and the references are appropriate, the quality of the data is high.
Author Response
Comment: Dear authors,
These are very interesting cases. Thank you for your detailed report. Could you get a little more into the problem that a definitve cause of the occlusions by COVID cannot be proved? Theoretically, there could be other reasons and the COVID infection a mere coincidence.
The main question is the presentation of 2 COVID-associated retinal occlusion cases. The 2 cases are interesting, but they do not fill any specific scientific gap. As far as I know, the paper does not add new information to the known literature. As these are mere case presentations, the main problem (is it really caused by COVID or just a coincidence) cannot be covered. The conclusions are consistent with the evidence, and the references are appropriate, the quality of the data is high.
Response to Comment 1:
Thank you for your comment and favorable comments related to the potential relationship between COVID and vascular occlusion, as well as the potential temporal nature of the association. The authors agree that while the prevalence for coagulopathy in COVID-19 infection warrants consideration of ocular vascular events, it’s important to recognize the broad differential that exists for ischemic ocular events. Therefore, we have added language to lines 163-166 that acknowledges this as a limitation.
Reviewer 2 Report
Comments and Suggestions for AuthorsThe authors presented an interesting case series of patients with CRVO and CRAO with severe COVID.
A few questions:
What were the transit times on fluorescein angiography? Was there delayed flow?
Given that CRVOs can be associated with hypertension, what were the BP ranges during hospitalization?
Overall an interesting case series.
Comments on the Quality of English LanguageCan you please review the grammar (i.e. line 53: maybe "she" failed?, line 160 remove “be”)?
Author Response
Comment:
What were the transit times on fluorescein angiography? Was there delayed flow?
Given that CRVOs can be associated with hypertension, what were the BP ranges during hospitalization?
Can you please review the grammar (i.e. line 53: maybe "she" failed?, line 160 remove “be”)?
Thank you for your insightful comments on the case. We acknowledge that including information such as transit times and blood pressure ranges would enhance the clinical picture that influenced the diagnosis and management. Accordingly, we have updated lines 157-162 to clarify why hypertension was less likely to have caused the ischemic event. The available FA interpretation information was included that support the diagnosis, management, and discussion items reviewed by the Reviewer.
Additionally, we agree with the Reviewer's grammar recommendations and have added the recommendations to our manuscript in lines 53 and 160.
