Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis with COVID-19 infection: A case report and literature review

COVID-19 Vaccine-Associated Optic Neuropathy: A Systematic Review of 45 Patients

“…It is, therefore, conceivable that both processes may have played a role in the development of optic neuropathy in the cases reported herein. This is also supported by reports on cases of optic neuritis that developed following COVID-19 infection and was suggested to be due to molecular mimicry between viral antigens, which are also partly present in the vaccines, and CNS proteins [ 82 , 83 , 84 ]. Another possible explanation for the development of post-vaccination optic neuropathy that could link inflammation and ischemia was recently elucidated by Francis and colleagues in patients that developed optic neuropathy with immune checkpoint inhibitors used for the treatment of cancer [ 85 ].…”

Optic neuropathies post-Covid 19 - review

“…In the articles in literature, an accurate diagnosis of postcovid optic neuropathy was carried out through an ophthalmological examination, in some cases associated with a neurological examination [7][8][9]. Imaging studies such as optical coherence tomography (OCT) [5,7,9,10,12,13,15,17], computer tomography (CT) [15], angiofluorography (AFG) [2,11], magnetic resonance imaging (MRI) [3-5,7-10,16-18], ultrasonography of the retrobulbar arteries [2], as well as laboratory, immunological and serological analyses were used. In order to clarify the etiological diagnosis and establish differential diagnoses with other infectious or autoimmune diseases, the following inflammatory tests were performed: erythrocyte sedimentation rate (ESR), ferritin, LDH, fibrinogen, CRP [2,4,6,7,8,13], D-dimers [2,6,12,14,16,17] immunological tests: rheumatoid factor (RF) [2,4,6,7,8,11,13,14,15], antinuclear antibodies (ANA), antineutrophil cytoplasmic antibodies (ANCA) [6,7], anti-aquaporin 4 antibodies (AQP4) [6], anti MOG IgG, antibodies IgG and IgM SARS-CoV-2; anti neuromyelitis optica antibodies (NMO), serology for syphilis, tuberculosis, cytomegalovirus, Lyme disease, Ebstein Barr virus, Herpes Simplex, human immunodeficiency virus, Borellia, hepa...…”

“…Most of the time, the retrobulbar inflammatory damage had a favorable evolution under early intravenous (i.v.) corticosteroid treatment, with the recovery of visual acuity (VA) and perimetric deficits [3,4,6,7,15,16]. In the case of papillitis, the evolution was good according to the ON treatment trial (ONTT) scheme [6] or with preservation of VA, but OCT changes at the level of the retinal nerve fiber layer (RNFL) [7].…”

“…Regarding the form of the Covid disease, most of the neuropathies described by the authors were found in the mild forms of the disease [2][3][4][5]7,[15][16][17][18], but there were also some moderate forms [6,8,13] requiring oxygen and general treatment with antibiotics and anticoagulants. In several other cases, the Covid disease took on serious forms, with severe complications [9][10][11][12] and hospitalization in the intensive care unit (ICU) and even OTI [12].…”

“…The ocular symptomatology with the onset of physiopathogenic phenomena that heralds an ON started most of the time two weeks after the positivity of the nasopharyngeal PCR test [4,5,7,9,13,16], but there were also cases with the onset of the disease in two and a half weeks [2], in three weeks [8,18], four weeks [6,17,18], six weeks [7,10], two months [18], or later, after a period of six months [7]. There was a rarity of the onset of the ON in the first days after the positivity of the PCR test, respectively in two days [11] or in seven days [3,15]. In some cases, due to the serious condition of the patients, the authors could not specify the time interval from the positivity of PCR to the appearance of ON [14].…”