CRVO associated with COVID-19 and MTHFR mutation in a 15-year-old male

Area of Science:

• Ophthalmology
• Infectious Diseases
• Genetics

Background:

• Central Retinal Vein Occlusion (CRVO) is a serious vascular condition affecting the eye.
• COVID-19 has been associated with various thrombotic events.
• Methylenetetrahydrofolate reductase (MTHFR) gene mutations are linked to hypercoagulability.

Observation:

• A 15-year-old male presented with acute, painless blurry vision in his left eye.
• Ophthalmic examination revealed signs consistent with CRVO, including optic nerve edema and intraretinal hemorrhages.
• Initial findings also suggested neuroretinitis, complicated by a positive COVID-19 test and a known MTHFR mutation.

Findings:

• The patient was diagnosed with CRVO in the context of COVID-19 infection.
• The presence of an MTHFR mutation indicated a pre-existing predisposition to clotting.
• Extensive workup ruled out other causes for the CRVO, strengthening the link to COVID-19.

Implications:

• This case underscores the potential for severe ocular complications, such as CRVO, following COVID-19 infection.
• It highlights the importance of considering COVID-19 in young patients presenting with vascular events, especially those with underlying clotting risks.
• The findings expand the understanding of the diverse ophthalmic manifestations of SARS-CoV-2 infection.