Neuro-ophthalmologic manifestations of corona virus disease (COVID-19): A case series

Abstract

Manifold neuro-ophthalmological signs & symptoms have been described in association with corona virus disease 19 (COVID-19). These presenting manifestations probably due to the result of a range of pathophysiological mechanisms throughout the course from acute illness to recovery phase & late recovery phase. Optic nerve dysfunction like optic neuropathy is associated with post COVID-19 infection. In this case series we want to highlight about the course, sequelae & association of optic neuropathy in COVID-19 patients.
 BSMMU J 2021; 14 (COVID -19 Supplement): 42-44

Optic neuropathies post-Covid 19 - review

“…Regarding the age distribution of post-Covid ON in the studied patients, most were aged within 31-60 years: 31-40 years [7,9,15,18], 41-50 years [4,8,11,17,18], 51-60 years [5,[12][13][14]16]. Few cases of ON were aged between 16 and 30 years [3,7,18] or 61-70 years [2,6,10].…”

“…From a clinical point of view, the optic neuropathies described by the authors were: retrobulbar (posterior) optic neuropathy in more cases [7,16,18], only one associated with MOG+ [7], anterior optic neuropathy (papillitis) [6,7], AION [2,13,14,18], from which one AAION [2] and the others NAION [13,14,18], one being related to pronation in an OTI patient with ARDS [14], neuroretinitis [18], suggested by the eye fundus with papillary edema with star-shaped associated with star-shaped macular exudates. It is difficult to specify the triggering mechanism of inflammatory optic neuropathies or ischemic optic neuropathies.…”

“…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].…”

“…Regarding the age distribution of post-Covid ON in the studied patients, most were aged within 31-60 years: 31-40 years [7,9,15,18], 41-50 years [4,8,11,17,18], 51-60 years [5,[12][13][14]16]. Few cases of ON were aged between 16 and 30 years [3,7,18] or 61-70 years [2,6,10]. A preponderance of ON post Covid was observed in the left eye (LE) [2,3,5,7-10,14,18], but without an important correlation between recovery and treatment; the right eye (RE) involvement was less common [6,13,11,18] and so was bilateral ocular involvement [4,12,[15][16][17].…”