ABSTRACT
A 40-year-old male presented with reduced vision in the right eye for one week. He had a history of nasopharyngeal carcinoma for which 34-Gy radiation was administered. The best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/20 in the left eye. Anterior segment examination suggested a bilateral early posterior subcapsular cataract. Fundoscopy revealed bilateral localized telangiectasia and macular edema in the right eye. Diagnosis of bilateral extremely delayed onset radiation retinopathy with right eye macular edema was made. Three doses of intravitreal bevacizumab injection were administered in the right eye. The patient was lost to follow-up due to COVID-19 and presented with recurrence.
Subject(s)
COVID-19 , Macular Edema , Nasopharyngeal Neoplasms , Retinal Diseases , Male , Humans , Adult , Macular Edema/diagnosis , Angiogenesis Inhibitors , Nasopharyngeal Carcinoma/diagnosis , Nasopharyngeal Carcinoma/radiotherapy , Nasopharyngeal Carcinoma/drug therapy , Communicable Disease Control , Bevacizumab , Retinal Diseases/diagnosis , Retinal Diseases/etiology , Retinal Diseases/drug therapy , Intravitreal Injections , Nasopharyngeal Neoplasms/diagnosis , Nasopharyngeal Neoplasms/radiotherapy , Nasopharyngeal Neoplasms/drug therapyABSTRACT
Background: During the outbreak period of COVID-19 pneumonia, cancer patients have been neglected and in greater danger. Furthermore, the differential diagnosis between COVID-19 pneumonia and radiation pneumonitis in cancer patients remains a challenge. This study determined their clinical presentations and radiological features in order to early diagnose and separate COVID-19 pneumonia from radiation pneumonitis patients promptly. Methods and Findings: From January 21, 2020 to February 18, 2020, 112 patients diagnosed with suspected COVID-19 were selected consecutively. A retrospective analysis including all patients' presenting was performed. Four patients from 112 suspected individals were selected, including 2 males and 2 females with a median age of 54 years (range 39-64 years). After repeated pharyngeal swab nucleic acid tests, 1 case was confirmed and 3 cases were excluded from COVID-19 pneumonia. Despite the comparable morphologic characteristics of lung CT imaging, the location, extent, and distribution of lung lesions between COVID-19 pneumonia and radiation pneumonitis differed significantly. Conclusions: Lung CT imaging combined with clinical and laboratory findings can facilitate early diagnosis and appropriate management of COVID-19 pneumonia with a history of malignancy and radiation therapy.