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Acute Ischemic Stroke With Central Retinal Artery Occlusion as a Rare Presentation of COVID-19 Disease

S K Jakaria Been Sayeed1, Subir Chandra Das2, Reaz Mahmud3

  • 1Medicine, National Institute of Neurosciences and Hospital, Dhaka, BGD.

Cureus
|September 30, 2021
PubMed

Insights

This case report details a patient experiencing ischemic stroke and central retinal artery occlusion after COVID-19. It highlights the need for further research into COVID-19

Area of Science:

  • Neurology
  • Ophthalmology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with inflammatory and pro-coagulant changes.
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binds to angiotensin-converting enzyme 2 (ACE2) receptors, initiating inflammatory pathways.
  • The impact of COVID-19 on cerebral and retinal vascular systems remains incompletely understood.

Observation:

  • A patient developed a border-zone ischemic stroke concurrently with central retinal artery occlusion (RAO).
  • This dual vascular event occurred following a diagnosis of COVID-19.
  • The combined presentation of central RAO and ischemic stroke following COVID-19 has not been previously documented.

Findings:

  • COVID-19-induced inflammation may contribute to thrombotic events in both arterial and venous circulation.
  • While ACE2 receptor binding is key to SARS-CoV-2 inflammation, central RAO pathogenesis is multifactorial.
  • The co-occurrence of ischemic stroke and central RAO suggests a potential link to COVID-19's vascular effects.

Implications:

  • This case underscores the complex and potentially severe neurological and ophthalmological complications of COVID-19.
  • Current treatment guidelines for this specific combined presentation are lacking.
  • Further research is warranted to understand the pathogenesis and establish treatment protocols for COVID-19-associated cerebroretinal vascular events.

Keywords:
case reportcentral retinal artery occlusioncovid-19ischemic strokerare presentation

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