Sonographic findings of COVID-19-related acute dacryoadenitis

Abstract

Objectives: To evaluate the ability of grayscale sonography and color Doppler sonography in determining the involvement of the lacrimal glands in coronavirus disease (COVID-19). Methods: A retrospective analysis was performed on a total of 25 COVID-19 patients with symptoms of acute dacryoadenitis and 25 healthy participants. The study’s inclusion criteria encompassed pain, swelling, and discomfort in the superior temporal aspect of the upper eyelid and orbit, consistent with acute dacryoadenitis occurring within 30 days of a positive test for SARS-CoV-2. PCR testing yielded positive results for all patients. Inclusion criteria for healthy participants included asymptomatic orbit and upper lid, no prior trauma or surgery involving the orbit, no evidence of upper respiratory tract infection consistent with SARS-CoV-2 in the past 6 months, and no history of systemic inflammatory disorders. The evaluation of the lacrimal gland and periorbital adipose tissue involved gray-scale and color Doppler ultrasonography to assess echogenicity, homogeneity, vascularity and enlargement of the lacrimal gland. The patients involved in the study underwent orbital examination and US evaluations repeated at 3 weeks and 3 months. Results: The mean age of the patients were 41.5±12.2 years (range, 18 to 63 years), while for the healthy participants, it was 34.4±5.2 years (range, 18 to 47 years). Significant differences were observed in the echogenicity (p=0.025), homogeneity (p=0.018), and vascularity (p<0.001), size (p<0.001) of the lacrimal gland between healthy participants and COVID-19 patients exhibiting symptoms of acute dacryoadenitis. However, no difference was noted in the perilacrimal fat tissue changes between COVID-19 patients with symptoms of acute dacryoadenitis and the control group (p=0.054). Conclusion: Gray-scale and color Doppler ultrasonography demonstrates as a valuable radiologic technique for assessing the acute onset involvement of the lacrimal glands in COVID-19.