Post-COVID-19 Retinal Manifestations in Pediatric Patient with Retinoblastoma: A Case Report

Abstract

Background The coronavirus disease 2019 (COVID-19) has been associated with various ocular manifestations, with limited literature on posterior segment findings in pediatric cases, especially in the context of retinoblastoma (RB). We present a unique case of a pediatric patient with unilateral RB who developed posterior uveitis and retinal vasculitis in the fellow eye following a COVID-19 infection. Case presentation A one-year and four-month-old boy with unilateral RB developed small retinal infiltrates and retinal vasculitis in the fellow eye at six months after a COVID-19 infection. Laboratory work-up did not identify infectious or specific autoimmune disorders. Given the critical nature of retinoblastoma, it raised concerns about a tumor-related cause in the fellow eye. Ancillary investigations, including fundus fluorescein angiography, were performed to differentiate RB-related changes. However, the results did not align with the typical features of RB. Spontaneous resolution of retinal lesions and retinal vasculitis was observed six weeks later. Conclusions Pediatric patients with posterior uveitis or retinal vasculitis post-COVID-19 should undergo comprehensive diagnostic workup, akin to adults, to exclude alternative causes before attributing it to SARS-CoV-2-induced immune responses. Notably, in unique cases like RB, a thorough evaluation of tumor-related cause is imperative.