Inner retinal layer ischemia and vision loss after COVID-19 infection: A case report

Sönmez, Hatice Kübra; Polat, Osman Ahmet; Erkan, Guzel

doi:10.1016/j.pdpdt.2021.102406

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…Systemic ocular manifestations of Covid-19 have been reported in numerous studies [4][5][6][7][8][9]. In contrast, the present study evaluated the role of steroid use in the development of these manifestations and also examined the effects of Covid-19 on ocular structures and choroidal thickness.…”

Section: Discussionmentioning

confidence: 88%

“…Ocular manifestations caused by Covid-19 have been reported such as episcleritis, conjunctivitis, keratitis, foreign body sensation, dry eye, epiphora or retinal vein occlusion due to thrombotic complications, and paracentral acute middle maculopathy (PAMM) [4][5][6]. Ocular involvement has been associated either directly with viral interaction or indirectly with the inflammatory response caused by the virus.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Corticosteroid Therapy on Choroidal Thickness in Patients With Covid-19 Infection: A Prospective, Comparative, and Observational Study

Sönmez¹,

Evereklioglu²,

Yüce³

et al. 2022

Cureus

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Background: Coronavirus disease 2019 has many different ocular manifestations. This study evaluates the effects of the disease and the steroid used in this disease on ocular structures.Purpose: To evaluate the effects of Covid-19 and the steroids used in the treatment of severe infection on ocular structures and choroidal thickness.Methods: This prospective study included 76 eyes of 76 patients who were hospitalized due to Covid-19 and 30 eyes of 30 healthy volunteering controls. Group I included 35 eyes who were hospitalized due to moderate-to-severe involvement that received steroid treatment, group II included 41 eyes with moderate involvement that did not require steroid treatment, and group III included 30 eyes with age-and gendermatched control subjects. Ophthalmological examination and imaging results of the patients obtained in the third week and third month after the diagnosis were compared between the groups.Results: Mean age of all participants was 40.2 ± 6.1 years. In the third week after the diagnosis of Covid-19, choroidal thickness in all regions (subfoveal, nasal, and temporal) was significantly greater in group I than in group II (for all, p<0.001). Moreover, choroidal thicknesses were significantly higher in group I and group II than in the control group (for all, p<0.001). In the third month, all the groups had similar choroidal thickness values (for subfoveal, nasal, and temporal; p=0.058, p=0.111, p=0.079, respectively). Conclusion: Our findings showed that Covid-19 infection causes choroidal thickening by affecting the choroidal layer and that steroid treatment further increases this thickness in the acute period. In addition, the reversal of this thickening to the normal level within a period of three months indicates that the effect of the disease on the choroid is reversible.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

The Effect of Corticosteroid Therapy on Choroidal Thickness in Patients With Covid-19 Infection: A Prospective, Comparative, and Observational Study

Sönmez¹,

Evereklioglu²,

Yüce³

et al. 2022

Cureus

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“…Most patients did not reveal any systemic symptoms associated with COVID-19 at the time of presentation for ocular symptoms, while two patients showed abnormal coagulation parameters, including D-dimer, ferritin, and D-dimer [ 49 , 52 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

Retinal vascular occlusions in COVID-19 infection and vaccination: a literature review

Yeo

Kim

Lee

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose Abnormal hypercoagulability and increased thromboembolic risk are common in patients with coronavirus disease (COVID-19). COVID-19 has been suggested to cause retinal vascular damage, with several studies on COVID-19 patients with retinal vascular occlusions. We reviewed and investigated studies on retinal vascular occlusions in patients diagnosed with COVID-19 and in those vaccinated for COVID-19. Methods Studies that reported retinal vascular occlusion in COVID-19 patients or in vaccinated people were identified using the terms “retinal occlusion,” together with “severe acute respiratory syndrome coronavirus 2”, “SARS-CoV-2,” “COVID-19,” “coronavirus,” and “vaccine,” through systematic searches of PubMed and Google Scholar databases until January 7, 2022. Results Thirteen cases of retinal artery occlusion (RAO) and 14 cases of retinal vein occlusion (RVO) were identified among patients diagnosed with COVID-19. Half of the patients with RAO or RVO revealed no systemic disorders except current or past COVID-19, and ocular symptoms were the initial presentation in five cases. Among patients with RAO, most presented with central RAO at 1–14 days of COVID-19 diagnosis, with abnormal coagulation and inflammatory markers. Among those with RVO, two-thirds presented with central RVO and one-third with RVO. Eleven cases with acute macular neuroretinopathy (AMN) and/or paracentral acute middle maculopathy (PAMM) were reported among patients with COVID-19, presenting scotoma resolved spontaneously in most cases. Among the 26 cases vaccinated with either mRNA or adenoviral vector vaccines for COVID-19 and presenting retinal vascular occlusions, there were more RVO cases than RAO cases, and ocular symptoms mostly occurred within 3 weeks after vaccination. One case presented bilateral AMN and PAMM after COVID-19 vaccination. Conclusion Retinal vascular occlusions might be a manifestation of COVID-19, although rare, especially in patients at risk of systemic hypercoagulability and thromboembolism. For COVID-19 vaccines, the causal relationship is controversial because there are few case reports of retinal vascular occlusions after COVID-19 vaccination.

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“…Optical coherence tomography angiography suggested focal reperfusion of the previous ischemic areas. 7…”

Section: Discussionmentioning

confidence: 99%

Paracentral Acute Middle Maculopathy After Covid-19: Multimodal Evaluation

Castro

Ferreira

Silva

et al. 2023

RETINAL Cases &Amp; Brief Reports

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Purpose: To report the case and multimodal imaging findings of a healthy young woman who developed paracentral acute middle maculopathy 9 weeks after COVID-19. Methods: Case report. Ultra-widefield fundus photography, macular spectral domain optical coherence tomography, fluorescein angiography, and optical coherence tomography angiography were performed. Results: A 36-year-old woman went to the emergency department with sudden, painless, left eye vision loss. The only relevant medical history was COVID-19 9 weeks before. The best-corrected visual acuity was 20/200, a left eye relative afferent pupillary defect was present, and superficial hemorrhages throughout the macular area and peripheral retina were found. Nearly 4 hours after admission, the left eye best-corrected visual acuity recovered to 20/20 without relative afferent pupillary defect. Five days after presentation in the emergency department, the patient returned with recurrent left eye vision loss, with spontaneous recovery within 12 hours. Macular spectral domain optical coherence tomography revealed hyperreflectivity of the inner plexiform and inner nuclear layers, and the diagnosis of paracentral acute middle maculopathy was established. The patient started oral acetylsalicylic acid and oral prednisolone. The patient did not report any new episodes of vision loss, and there was a progressive resolution of abnormal fundus findings. Conclusion: SARS-CoV-2 infection increases the risk of vascular thrombotic events with possible involvement of the retinal circulation, and paracentral acute middle maculopathy may present as a possible complication. Ophthalmologists should be able to recognize it promptly through multimodal imaging findings.

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Inner retinal layer ischemia and vision loss after COVID-19 infection: A case report

Cited by 9 publications

References 13 publications

The Effect of Corticosteroid Therapy on Choroidal Thickness in Patients With Covid-19 Infection: A Prospective, Comparative, and Observational Study

The Effect of Corticosteroid Therapy on Choroidal Thickness in Patients With Covid-19 Infection: A Prospective, Comparative, and Observational Study

Retinal vascular occlusions in COVID-19 infection and vaccination: a literature review

Paracentral Acute Middle Maculopathy After Covid-19: Multimodal Evaluation

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