Neuro-ophthalmic presentation of COVID-19 disease

Katti, Venkatram; Ramamurthy, Lakshmi B; Kanakpur, Savitha; Shet, Satish D.; Dhoot, Manisha

doi:10.4103/ijo.ijo_3321_20

Cited by 18 publications

(6 citation statements)

References 10 publications

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“…In our review of the literature, 2 patients had the presence of a known macroadenoma 9 while the others presented with PA as the first presenting sign. [6][7][8]10,11,[13][14][15] Only 1 case presented with PA in the absence of an underlying pituitary tumor. 12 Adding our cases with the others that were already described, there are now 15 cases of patients who presented with PA after contracting a COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Infection, A Risk Factor for Pituitary Apoplexy? A Case Series and Literature Review

et al. 2023

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Introduction: Pituitary apoplexy (PA) is a rare phenomenon, characterized by a hemorrhagic or ischemic event of the pituitary gland, most often in association with a pituitary lesion. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the strain of virus responsible for the internationally recognized global pandemic COVID-19. Multiple clinical manifestations associated with this virus have been described, ranging from asymptomatic, mild flu symptoms to acute respiratory distress syndrome, end-organ failure leading to death. Cases of patients with concomitant COVID-19 infections and PA are being further recognized in the literature, but the causal association between the 2 entities remains speculative. Objectives: The objectives of this case series are 3-fold: to describe additional cases of patients with concomitant COVID-19 infection and PA (1), to review the current evidence regarding this potential complication associated with a COVID-19 infection (2), and to discuss physiopathological hypotheses, treatments, and prognoses of this newly recognized association (3). Method: We conducted an electronic chart review of patients treated for PA with concomitant COVID-19 infection from March 2020 to December 2021. A literature review was performed using MEDLINE, Web of Science, and Embase databases to identify other cases of COVID-19-associated PA. Results: From March 2020 to December 2021, 3 patients presented to our center with PA following a symptomatic COVID-19 infection. Two of these patients developed PA symptoms days following the viral infection, whereas the third patient developed PA after a 2-month period. The 2 first patients were managed surgically because of persistent visual symptoms. Results from our literature review yielded 12 other cases of COVID-19-associated PAs. Conclusions: The association between COVID-19 infection and PA has been increasingly reported in the literature. With the addition of the 3 cases described in our article, a total of 15 cases have been published. Many contributing mechanisms may lead to PA following COVID-19 infection. Coagulopathy is probable major contributing cause responsible for hemorrhage or infarction of the pituitary gland. Our case series provides further arguments that PA may be a direct manifestation of a COVID-19 infection.

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Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Infection, A Risk Factor for Pituitary Apoplexy? A Case Series and Literature Review

et al. 2023

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“…The condition was also attributable to pituitary apoplexy. Similarly, a case of optic neuritis concomitant with pituitary apoplexy in a patient with previously undiagnosed pituitary non-secreting macroadenoma was reported in the context of active COVID-19 infection [ 15 ]. However, the case we described did not have pituitary apoplexy, and therefore, the second question could not also be answered.…”

Section: Discussionmentioning

confidence: 99%

Optic neuritis concomitant with pituitary macroadenoma in a patient with active COVID-19 infection: A case report

Al-Salihi

Rahman²,

Al-Jebur

et al. 2021

International Journal of Surgery Open

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Introduction and importance Several neuro-ophthalmic manifestations have been reported with coronavirus disease 2019 (COVID-19) infection. However, isolated optic neuritis was infrequently reported in humans with COVID-19. If it occurred, optic neuritis was usually a part of a demyelinating syndrome. Case presentation In this paper, we report a case of optic neuritis concomitant with an undiagnosed pituitary macroadenoma discovered during active COVID-19 infection. The case was a 33-year-old woman with infertility who was recently found to have a pituitary macroadenoma secreting prolactin. During active COVID-19 infection, the patient developed optic neuritis that responded well to corticosteroids. Brain imaging and hormonal profile negated the presence of any demyelinating disease or pituitary apoplexy. Clinical discussion A dilemma of whether optic neuritis occurring concomitantly with pituitary macroadenoma is just a coincidence, or there is an association remains unresolved. Whether COVID-19 infection might precipitate optic neuritis in patients with pituitary macroadenoma or not remains an issue to be answered by observing data from future case reports about similar findings. Conclusion Optic neuritis in concomitant with pituitary macroadenoma following COVID-19 infection represents a dilemma of whether the visual symptoms are attributed to the tumor or COVID-19 infection.

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“…Additionally, cases of vision loss due to pituitary infarction have been reported in the setting of COVID-19. 110 , 111 …”

Section: Ophthalmological Symptoms In the Course Of Covid-19mentioning

confidence: 99%

The Review of Ophthalmic Symptoms in COVID-19

Stawowski,

Konopińska,

Stawowski

et al. 2024

OPTH

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The COVID-19 pandemic caused by SARS-CoV-2 had a significant impact on the health of the global human population, affecting almost every human organ, including the organ of vision. Research focus on understanding the pathophysiology, identifying symptoms and complications of the disease. Eye-related pathologies are important foci of research due to the potential for direct impact of the virus. Ophthalmologists around the world are reporting various symptoms of eye infections and ocular pathologies associated with SARS-CoV-2. The review of ophthalmic symptoms was conducted to help physicians of various specialties recognize possible ophthalmic manifestations of this viral disease. A literature review was conducted from January 2020 to July 2023 in the PubMed, MEDLINE, Science Direct, Scopus, Scielo and Google Scholar databases. The review of the literature showed that conjunctivitis is the most common ophthalmic symptom observed during the course of COVID-19 and can occur at any stage of the disease. Changes in the eye may result from the direct effect of the virus, immune response, prothrombotic states, comorbidities, and medications used. Symptoms related to the organ of vision can be divided into: changes affecting the protective apparatus of the eye, the anterior eye segment, the posterior eye segment, neuro-ophthalmic, and orbital changes. Ocular symptoms may suggest COVID-19 infection or appear several weeks after recovery. Following COVID-19 vaccinations, a diverse range of ophthalmic symptoms was observed in various locations and at different times, mirroring the ocular symptoms experienced throughout the course of the COVID-19 illness. It is important for physicians of all specialties to be aware of possible potential connections between eye diseases and SARS-CoV-2, in order to effectively diagnose and treat patients.

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Neuro-ophthalmic presentation of COVID-19 disease

Cited by 18 publications

References 10 publications

SARS-CoV-2 Infection, A Risk Factor for Pituitary Apoplexy? A Case Series and Literature Review

SARS-CoV-2 Infection, A Risk Factor for Pituitary Apoplexy? A Case Series and Literature Review

Optic neuritis concomitant with pituitary macroadenoma in a patient with active COVID-19 infection: A case report

The Review of Ophthalmic Symptoms in COVID-19

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