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Symptomatic Retinal Microangiopathy in a Patient with Coronavirus Disease 2019 (COVID-19): Single Case Report
Julio J Gonzalez-Lopez1, Beatriz Felix Espinar1, Cristina Ye-Zhu1
1Ophthalmology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Madrid, Spain.
Insights
Late-phase Coronavirus Disease 2019 (COVID-19) can cause vision loss from retinal microvascular ischemia. This case highlights potential ocular complications, including visual field defects, during COVID-19 recovery.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Vascular Medicine
Background:
- Coronavirus Disease 2019 (COVID-19) is linked to ocular manifestations, including conjunctivitis and retinal vascular changes.
- Retinal microvascular ischemia has been observed in patients with COVID-19, even those asymptomatic.
Observation:
- A 50-year-old male with COVID-19 pneumonia presented with a left arcuate visual field defect.
- Funduscopy showed bilateral cotton-wool spots, and OCT-angiography confirmed multifocal retinal microvascular ischemia.
Findings:
- The patient experienced visual field defects attributed to retinal microangiopathy during the late phase of COVID-19.
- OCT-angiography findings correlated with the observed visual field deficits.
Implications:
- Retinal microangiopathy and associated visual field defects can manifest in the late stages of COVID-19.
- Ocular findings may serve as indicators of systemic vascular changes in less accessible organs due to COVID-19.
Abstract:
Purpose: Coronavirus Disease 2019 (COVID-19) can cause conjunctivitis in up to 31.6% of patients. Additionally, retinal findings compatible with retinal microvascular ischemia have also been associated with coronavirus disease in asymptomatic patients. We describe a case of bilateral retinal changes compatible with microangiopathy occurring during the late phase of COVID-19.Case report: A 50-year-old man with bilateral pneumonia and positive polymerase chain reaction for SARS-CoV-2 developed an arcuate visual field defect in his left eye. Funduscopy revealed multiple, bilateral cotton-wool spots without haemorraghes. OCT-angiography revealed multifocal areas of retinal microvascular ischemia in the superficial plexus, the largest of which corresponded to the arcuate scotoma observed in the automated perimetry.Conclusion: Visual field defects due to retinal microangiopathy can occur during the late phase of COVID-19. Vascular changes observed in the retina may mimic what may be happening in other, less-accessible organs.
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