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Published on: November 12, 2020
Case Report: Central Retinal Artery Occlusion in a COVID-19 Patient
Andrea Montesel1, Claudio Bucolo2, Victoria Mouvet1
1Department of Ophthalmology, Fondation Asile des Aveugles, Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.
Insights
Severe COVID-19 may increase the risk of central retinal artery occlusion (CRAO). Ophthalmological surveillance is advised for COVID-19 patients to prevent vision loss from CRAO.
Area of Science:
- Ophthalmology
- Cardiology
- Infectious Diseases
Background:
- COVID-19 is linked to inflammatory changes, endothelial dysfunction, and a procoagulant state.
- The risk of thromboembolic complications in COVID-19 patients remains unclear.
- Retinal artery occlusions result from multifactorial processes including inflammation and hypercoagulation.
Observation:
- A case of central retinal artery occlusion (CRAO) occurred in a patient with a history of severe COVID-19.
- This suggests a potential association between severe COVID-19 and retinal vascular events.
Findings:
- COVID-19 may contribute to a hypercoagulable state, increasing the risk of retinal vascular occlusions.
- Inflammation and hypercoagulation are known risk factors for retinal artery occlusions.
Implications:
- COVID-19 patients may be at increased risk for retinal vascular occlusions.
- Focused ophthalmological surveillance is recommended for early detection and management of CRAO in COVID-19 survivors.
- Preventing vision loss from CRAO is crucial for managing healthcare system impact.
Abstract:
We report a case of central retinal artery occlusion (CRAO) in a patient with a previous history of severe COVID-19 disease. This disease has been associated with inflammatory-induced homeostasis changes leading to endothelial dysfunction and a procoagulant state with multi-organ involvement, but the burden of thromboembolic complications in COVID-19 patients is currently unknown. The pathogenesis of retinal artery occlusions is a multifactorial process where inflammation and hypercoagulation state are established risk factors. Even if our experience may represent a coincidental relationship, it is likely that COVID-19 patients could be at risk of developing retinal vascular occlusions. A focused ophthalmological surveillance is advisable to prevent and manage this possible cause of severe vision loss that has an important impact in health care system.
