Response to comments on: Evaluating the presence of SARS-CoV-2 in the intraocular fluid of COVID-19 patients.

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.