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Bilateral Simultaneous Central Retinal Vein Occlusion Secondary to COVID-19: A Case Report

Chien-Hung Lin1, I-Ting Sun2

  • 1Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.

Case Reports in Ophthalmology
|February 23, 2023
PubMed

Insights

Coronavirus disease 2019 (COVID-19) can cause bilateral simultaneous central retinal vein occlusion (CRVO). This case highlights the importance of recognizing ocular symptoms associated with COVID-19.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Cardiovascular Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with various thromboembolic complications.
  • Coagulation abnormalities, including elevated D-dimer and C-reactive protein (CRP), are frequently observed in COVID-19 patients.
  • Central retinal vein occlusion (CRVO) is a serious ocular vascular event.

Observation:

  • A 48-year-old male with hypertension, type 2 diabetes mellitus, and stage 4 chronic kidney disease presented with bilateral blurred vision.
  • Ophthalmological examination confirmed bilateral simultaneous central retinal vein occlusion (CRVO).
  • Optical coherence tomography revealed significant macular edema with intraretinal and subretinal fluid in both eyes.

Findings:

  • Laboratory results showed elevated D-dimer and CRP levels, indicating a hypercoagulable state.
  • Despite normal levels of other hypercoagulability markers, the clinical presentation strongly suggested a COVID-19-related thrombotic event.
  • The patient responded well to intravitreal anti-vascular endothelial growth factor therapy, leading to symptom resolution and improved retinal vascular appearance.

Implications:

  • This case underscores the potential for COVID-19 to trigger severe ocular vascular events like bilateral CRVO.
  • Ophthalmologists and healthcare providers should consider COVID-19 as a potential underlying cause for CRVO, especially in patients with relevant risk factors.
  • Increased awareness of COVID-19-associated ocular manifestations is crucial for timely diagnosis and management, potentially preventing vision loss.

Keywords:
COVID-19Central retinal vein occlusionThromboembolic complication

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