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Six Cases of Retinal Vascular Anomalies after Coronavirus Disease 2019: A Case Series
Georgios N Tsiropoulos1,2,3, Daniela Gallo Castro1,2, Aude Ambresin1,2,4
1RétinElysée, Ophthalmology Center, Lausanne, Switzerland.
Insights
COVID-19 can cause serious retinal vascular issues, including inflammation and blockages, weeks or months after infection. Prompt eye examinations are crucial for diagnosing and managing these long-term ocular effects.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Vascular Medicine
Background:
- The COVID-19 pandemic has revealed novel ophthalmological manifestations.
- This study investigates retinal vascular anomalies following SARS-CoV-2 infection.
Observation:
- Patients presented with symptoms like vision loss and scotoma.
- Best-corrected visual acuity was largely preserved, with one case of reduced acuity.
Findings:
- Retinal vasculitis, branch retinal vein occlusion, branch retinal artery occlusion, and central retinal vein occlusion with optic disc edema were observed.
- These conditions occurred 0-8 months post-COVID-19.
- Serological testing excluded other causes and confirmed immunity.
Implications:
- Retinal vascular pathologies, both occlusive and inflammatory, are potential long-term ocular complications of COVID-19.
- These conditions should be considered in the differential diagnosis of retinal vascular occlusive diseases.
- Fundoscopy and fluorescein angiography are recommended for visual complaints during and after COVID-19.
Background:
The novel coronavirus disease 2019 (COVID-19) and its rapid spread has resulted in unexplored clinical ophthalmological manifestations. This report aims to describe a series of retinal vascular anomalies diagnosed with the use of fluorescein angiography, following contraction of COVID-19.
History And Signs:
Symptoms reported by patients were central scotoma (one case), inferior scotoma (one case), and a sensation of mild loss of vision during the COVID-19 follow-up (four cases). Best-corrected visual acuity was preserved in all patients, apart from one, who had a visual acuity of 0.4, decimal scale (6/15, Snellen) in the left eye.
Therapy And Outcome:
Clinical manifestations included bilateral retinal vasculitis (two cases), branch retinal vein occlusion (one case), branch retinal artery occlusion (one case), hemi-central retinal vein occlusion (one case), and optic disc edema due to central retinal vein occlusion (one case) occurring 0 - 8 months after COVID-19 contraction. Serological testing was performed in every patient to exclude any other recognized cause of retinal vascular occlusion and inflammation and to confirm immunity against the novel coronavirus. None of the patients required any ocular treatment.
Conclusions:
Arterial and venous occlusive as well as inflammatory retinal vascular pathologies can occur both during and after the acute phase of COVID-19 as manifestations of ocular long-term effects of COVID-19 and should be included in the differential diagnosis of retinal occlusive pathologies. This case series suggests that careful investigations, including fundoscopy and fluorescein angiography, should be required in patients with visual complaints, both in the acute and long-term follow-up of COVID-19.
