Small case study of retinopathy associated with novel coronavirus infection / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

AIM: To observe the clinical and multimodal imaging features of retinopathy associated with novel coronavirus disease 2019(COVID-19)infection, investigate the related risk factors, and analyze the treatment and prognosis.METHODS: A total of 7 patients(7 eyes)with clinically confirmed COVID-19-associated retinopathy in Tianjin Medical University General Hospital from December 13, 2022 to January 13, 2023 were included in the study. All patients underwent color fundus photography, IR, spectral-domain optical coherence tomography(SD-OCT), fundus autofluorescein(FAF)and other ophthalmic examination and serological examination.RESULTS: Among the included patients, 2 cases(2 eyes)of central retinal vein occlusion(CRVO)appeared differently from previous CRVO. The hemorrhagic features of CRVO were round or fusiform shape hemorrhagic spots with white centers. One of them, the von Willebrand factor antigen(vWF: Ag)level was increased to 161.8%. The other case was positive in serologic test for lupus anticoagulant. In 2 cases(2 eyes)of multiple evanescent white dot syndrome(MEWDS), FAF showed that dots of high spontaneous fluorescence were scattered in the posterior pole. The prognosis of 2 MEWDS were good after the treatment of glucocorticoids. The 3 cases(3 eyes)of acute macular neuroretinopathy(AMN)showed reddened brown lesions in the macular area, hyporeflective lesions with clear boundaries on IR, and high signal intensity in the ONL and ELM, EZ/IZ signal fracture on SD-OCT.CONCLUSION: COVID-19 may cause inflammatory storm, involving all layers of retinal tissues and blood vessels, leading to the occurrence of various retinal lesions. Hormone therapy may be effective and the prognosis is good in most cases. Roth spot can be seen in fundus hemorrhage of CRVO, lupus anticoagulant and increased vWF: Ag may be risk factors for CRVO after COVID-19.