RESUMEN
Coronavirus disease 2019 (COVID-19) is a procoagulant disease that increases the risk of clinically evident thrombotic complications. Herein we present 3 cases with different retinal artery occlusions that emerged soon after the diagnosis of COVID-19. The first patient had central retinal artery occlusion (CRAO) that resulted in visual loss in one eye. The second patient had inflammatory peripheral retinal artery occlusion, vasculitis, and uveitis which did not affect vision. The third patient presented with CRAO following the progression from orbital cellulitis to orbital apex syndrome. Interestingly, CRAO progressed to internal carotid artery occlusion in this case within days and resulted in monocular visual loss. Variations in the underlying pathophysiology and the characteristics of individual immune responses in patients with COVID-19 may be factors that determine differences in clinical manifestations. This article aims to describe different presentations of COVID-19-related retinal artery occlusions and discuss possible pathophysiological aspects.
Asunto(s)
COVID-19 , Oclusión de la Arteria Retiniana , Humanos , COVID-19/complicaciones , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/etiología , Retina , CegueraRESUMEN
PURPOSE: Abnormal hypercoagulability and increased thromboembolic risk are common in patients with coronavirus disease (COVID-19). COVID-19 has been suggested to cause retinal vascular damage, with several studies on COVID-19 patients with retinal vascular occlusions. We reviewed and investigated studies on retinal vascular occlusions in patients diagnosed with COVID-19 and in those vaccinated for COVID-19. METHODS: Studies that reported retinal vascular occlusion in COVID-19 patients or in vaccinated people were identified using the terms "retinal occlusion," together with "severe acute respiratory syndrome coronavirus 2", "SARS-CoV-2," "COVID-19," "coronavirus," and "vaccine," through systematic searches of PubMed and Google Scholar databases until January 7, 2022. RESULTS: Thirteen cases of retinal artery occlusion (RAO) and 14 cases of retinal vein occlusion (RVO) were identified among patients diagnosed with COVID-19. Half of the patients with RAO or RVO revealed no systemic disorders except current or past COVID-19, and ocular symptoms were the initial presentation in five cases. Among patients with RAO, most presented with central RAO at 1-14 days of COVID-19 diagnosis, with abnormal coagulation and inflammatory markers. Among those with RVO, two-thirds presented with central RVO and one-third with RVO. Eleven cases with acute macular neuroretinopathy (AMN) and/or paracentral acute middle maculopathy (PAMM) were reported among patients with COVID-19, presenting scotoma resolved spontaneously in most cases. Among the 26 cases vaccinated with either mRNA or adenoviral vector vaccines for COVID-19 and presenting retinal vascular occlusions, there were more RVO cases than RAO cases, and ocular symptoms mostly occurred within 3 weeks after vaccination. One case presented bilateral AMN and PAMM after COVID-19 vaccination. CONCLUSION: Retinal vascular occlusions might be a manifestation of COVID-19, although rare, especially in patients at risk of systemic hypercoagulability and thromboembolism. For COVID-19 vaccines, the causal relationship is controversial because there are few case reports of retinal vascular occlusions after COVID-19 vaccination.
Asunto(s)
COVID-19 , Oclusión de la Arteria Retiniana , Enfermedades de la Retina , Oclusión de la Vena Retiniana , Trombofilia , Humanos , Vacunas contra la COVID-19/efectos adversos , Prueba de COVID-19 , COVID-19/complicaciones , COVID-19/epidemiología , SARS-CoV-2 , Enfermedades de la Retina/complicaciones , Oclusión de la Vena Retiniana/diagnóstico , Oclusión de la Vena Retiniana/etiología , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/etiología , Vacunación/efectos adversos , Trombofilia/complicacionesRESUMEN
We describe a 68-year-old female patient with unilateral central retinal artery occlusion (CRAO) with cilioretinal artery sparing post-coronavirus disease 2019 (COVID-19) infection. The patient presented with acute vision loss in the left eye 11 days after discharge from a severe COVID-19 infection, with altered D-dimer, C-reactive protein, and fibrinogen levels. The best-corrected visual acuity (BCVA) in the left eye was 20/400; fundoscopic examination revealed diffuse pallor retina with a patent arterial branch from the optic disk to the fovea, confirmed by fluorescein angiography. CRAO with a cilioretinal artery sparing post-COVID-19 may be considered an additional ocular manifestation of the post-acute COVID-19 syndrome spectrum.
Asunto(s)
COVID-19 , Conjuntivitis , Oclusión de la Arteria Retiniana , Arteria Retiniana , Anciano , Femenino , Humanos , COVID-19/complicaciones , Angiografía con Fluoresceína , Retina , Oclusión de la Arteria Retiniana/etiología , Vasos RetinianosAsunto(s)
COVID-19 , Oclusión de la Arteria Retiniana , Enfermedades de la Retina , Oclusión de la Vena Retiniana , Humanos , Incidencia , Prueba de COVID-19 , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/epidemiología , Oclusión de la Arteria Retiniana/etiología , Oclusión de la Vena Retiniana/diagnóstico , Oclusión de la Vena Retiniana/epidemiología , Oclusión de la Vena Retiniana/etiología , Enfermedades de la Retina/complicacionesAsunto(s)
COVID-19 , Oclusión de la Arteria Retiniana , Enfermedades de la Retina , Oclusión de la Vena Retiniana , Humanos , Incidencia , Prueba de COVID-19 , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/epidemiología , Oclusión de la Arteria Retiniana/etiología , Oclusión de la Vena Retiniana/diagnóstico , Oclusión de la Vena Retiniana/epidemiología , Oclusión de la Vena Retiniana/etiología , Enfermedades de la Retina/complicacionesAsunto(s)
Vacunas contra la COVID-19 , COVID-19 , Oclusión de la Arteria Retiniana , Oclusión de la Vena Retiniana , COVID-19/patología , Vacunas contra la COVID-19/efectos adversos , Humanos , Oclusión de la Arteria Retiniana/etiología , Oclusión de la Vena Retiniana/etiología , SARS-CoV-2 , Vacunación/efectos adversosRESUMEN
In late 2019, we saw the emergence of a new coronavirus, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which rapidly evolved into a global pandemic. We report two cases of ocular vascular occlusion related to coronavirus disease 2019 (COVID-19) disease. The first case is of choroidal artery occlusion, while the second case is of combined central retinal artery and vein occlusion (CRAO and CRVO). We performed a thorough literature search and to the best of our knowledge, neither any of the above said has been reported in COVID-19-positive patients.
Asunto(s)
COVID-19 , Oclusión de la Arteria Retiniana , Oclusión de la Vena Retiniana , Ojo , Humanos , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/etiología , Oclusión de la Vena Retiniana/diagnóstico , Oclusión de la Vena Retiniana/etiología , SARS-CoV-2RESUMEN
COVID-19-associated coagulopathy (CAC) has led to an increase in the incidence of large vessel stroke and cryptogenic shock. We present a case of a 30-year-old COVID-19-positive patient who developed an internal carotid artery (ICA) thrombosis, which led to ischemic stroke, aphasia, and unilateral blindness. Ophthalmic artery occlusion (OAO) was found to be the cause of vision loss. We thereby aim to highlight the detailed ophthalmic manifestations of OAO with features of posterior ciliary artery occlusion (PCAO) in this patient with proven ICA thrombosis.
Asunto(s)
COVID-19 , Accidente Cerebrovascular Isquémico , Oclusión de la Arteria Retiniana , Accidente Cerebrovascular , Adulto , COVID-19/complicaciones , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico , Accidente Cerebrovascular Isquémico/etiología , Arteria Oftálmica , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/etiología , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiologíaAsunto(s)
COVID-19/complicaciones , Mucormicosis/diagnóstico , Oclusión de la Arteria Retiniana/diagnóstico , Arteria Retiniana/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Adulto , Femenino , Angiografía con Fluoresceína , Humanos , Imagen por Resonancia Magnética , Oclusión de la Arteria Retiniana/etiología , SARS-CoV-2RESUMEN
A 54-year-old male patient applied to our clinic with a sudden and painless loss of vision in his right eye. He was suffering from COVID-19. His best-corrected visual acuity of the right eye was finger counting from 30 cm. The fundus examination revealed the presence of a 'cherry-red spot' appearance in the right eye. In optical coherence tomography imaging, hyper-reflectivity was observed in the inner retinal layers as well as increased retinal thickness in the right eye. In fundus fluorescein angiography, delayed arterial filling and prolonged arteriovenous transit time were observed in the right eye. The patient was diagnosed with central retinal artery occlusion after the COVID-19 infection. In this study, we report this case and its management.
Asunto(s)
COVID-19 , Oclusión de la Arteria Retiniana , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Masculino , Persona de Mediana Edad , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/etiología , SARS-CoV-2 , Tomografía de Coherencia ÓpticaRESUMEN
Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic, is associated with inflammatory-induced hypercoagulation leading to multisystemic involvement, including the retina. Case Presentation: We report a unique case of branch retinal artery occlusion that occurred 5 weeks after a relatively mild COVID-19. After excluding all systemic disorders that may have caused retinal artery occlusion and noticing an elevation in the D-dimer level, the case was considered as a late complication of the SARS-CoV-2 infection. Discussion: As branch retinal artery occlusion occurred 5 weeks after COVID-19 in this case, ophthalmologists should keep in mind that late thromboembolic events which can be associated with SARS-CoV-2 infection may occur.