Retinal vasoocclusive spectrum following COVID-19
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Published on: May 25, 2022
Daraius Shroff1, Sandeep Kumar1, Anushree Naidu1
1Retina and Vitreous, Shroff Eye Centre, New Delhi, India.
Insights
Coronavirus disease (COVID-19) can cause blood clots, leading to eye conditions like retinal artery or vein occlusion. This study links elevated D-dimer levels in COVID-19 patients to these vision-threatening vaso-occlusive events.
Area of Science:
- Ophthalmology
- Hematology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) is associated with hypercoagulability and thromboembolic complications.
- Ocular manifestations of COVID-19, while uncommon, are increasingly reported.
- Understanding the link between COVID-19 and retinal vascular events is crucial for patient management.
Observation:
- A case series of four patients with confirmed COVID-19 infection presented with various retinal vascular occlusions.
- These included central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), and central retinal artery occlusion (CRAO).
- One patient also experienced vitreous hemorrhage.
Findings:
- All patients had proven COVID-19 and no other significant systemic comorbidities.
- Elevated D-dimer levels were observed, indicating a prothrombotic state.
- A correlation was noted between elevated D-dimer and retinal vaso-occlusive phenomena, leading to significant visual morbidity.
Implications:
- COVID-19 may increase the risk of retinal vascular occlusive events.
- Elevated D-dimer in COVID-19 patients could serve as a marker for potential ocular complications.
- Further research is warranted to elucidate the mechanisms and guide preventative strategies for ocular complications in COVID-19.
Abstract:
The coagulation abnormalities and thromboembolic complications of coronavirus 2 (SARS-CoV-2) are now a well-established fact. The hypercoagulable state, the tendency for thromboembolism, and a cytokine surge state have been the exclusive reasons for multiorgan failure and other morbidities that have been regularly reported in COVID-19 patients. Ocular involvement in patients with active disease and those who have recovered is uncommon but not rare. We report a case series of four patients with CRVO, BRVO, CRAO, and vitreous hemorrhage in patients with proven COVID-19 infection and no other systemic ailments. The case series also tries to correlate the elevated D-dimer values, which signify a plausible prothrombotic state with the vaso-occlusive phenomenon in the retina leading to significant visual morbidity.
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