A review by Wayne State University School of Medicine researcher Ashok Kumar, Ph.D., professor of Ophthalmology, Visual and Anatomical Sciences, on the Monkeypox virus and its ability to cause ocular complications has gained the attention of the National Institutes of Health and one of his field’s leading journals.
The review, “Mpox Virus and its ocular surface manifestations,” published in The Ocular Surface, underscores the importance of understanding how viruses like Monkeypox, or Mpox, affect eye health and highlights recent advances in diagnosing and managing the conditions.
The World Health Organization declared Mpox a public health emergency of international concern on July 27. Given the importance of the public health concern and ocular complications, the National Eye Institute of the National Institutes of Health released a media advisory about Dr. Kumar’s research last month.
Dr. Kumar was interviewed by Ophthalmology News for a Sept. 10 article in which he and his collaborator answer why the Mpox virus is spreading and the related research they are conducting.
Mpox virus, or MPXV, is the causative agent of human monkeypox disease, a debilitating rash illness like smallpox. There are three clades of the virus: Clade I, Clade IIa and Clade IIb. While Clade I MPXV remains endemic to West and Central Africa, Clade II MPXV has caused numerous outbreaks worldwide. The 2022 outbreak in the United States was driven by the rapid spread of Clade IIb, a distinct lineage from previous strains, Dr. Kumar said.
“In the eye, MPXV causes a spectrum of ophthalmic manifestations referred to as ocular Mpox, which varies in severity from moderate to severe, with ocular surface complications such as keratitis, conjunctivitis and blepharitis being the most common,” Dr. Kumar said. “My laboratory, in collaboration with Dr. Vaithi Arumugaswami at University of California Los Angeles, has developed models to study the host and viral determinants of ocular Mpox. We plan to clone genes of Clade IIb to determine why it spreads so quickly and its tropism toward ocular tissues.”
While basic research is underway in the Kumar lab, the review discusses the viral and genomic structures of MPXV, the epidemiology and pathology of systemic and ocular Mpox, and potential preventive and therapeutic measures.
“My laboratory studies ocular infectious disease, and since the Mpox virus infection was implicated in causing ocular complications in 1% to 10% of individuals, I decided to work on this problem and reached out to my collaborator, and we started working on it together in 2023,” Dr. Kumar said.
The review focuses on the pathophysiology, diagnosis and treatment of viral infections affecting the eye, including Monkeypox, which has gained global attention after its resurgence in non-endemic countries. The research team emphasizes that while Monkeypox is primarily known for causing skin lesions and systemic symptoms, its potential ocular complications, including conjunctivitis, keratitis and vision loss, warrant greater clinical attention. The review highlights the current state of knowledge but also stresses the urgent need for global public health initiatives to address the eye health risks posed by viral outbreaks like Monkeypox.
“The rapid spread of Monkeypox in recent years has illuminated gaps in our understanding of its full spectrum of symptoms, particularly in the field of Ophthalmology. Our review aims to fill these gaps by providing a comprehensive overview of the virus’s ocular manifestations, which have historically been underreported and under-researched,” Dr. Kumar said.
The review suggests that early detection and timely intervention can mitigate the risk of long-term ocular damage. It also calls for more focused research into the mechanisms of viral-induced ocular diseases, including the need for antiviral therapies and vaccines that can prevent or minimize eye-related complications.