Patient: Female, 69-year-old Final Diagnosis: Anterior ischemic neuropathy • giant cell arteritis Symptoms: Headache • tenderness • vision loss Medication: — Clinical Procedure: — Specialty: Ophthalmology Objective: Rare disease Background: Giant cell arteritis (GCA) is an inflammation of large vessels that affects the lining of the arteries and leads to vessel swelling and the eventual reduction of blood flow. This can result in ischemia of the optic nerve, which is known as arteritic anterior ischemic optic neuropathy (AAION). The present case seems noteworthy because the patient developed GCA with the ocular manifestation of AAION shortly after having COVID-19. Case Report: A 69-year-old woman was admitted to the Clinic of Ophthalmology after having COVID-19. She reported vision loss in the left eye, which appeared 2.5 weeks after a positive SARS-CoV-2 test. While in the hospital, she was diagnosed with AAION and GCA. The patient was treated with enoxaparin sodium, prednisone, and methotrexate. Three months after the hospitalization, the visual acuity of the left eye was limited to light perception, and optic nerve atrophy was reported. Conclusions: We would like to emphasize the role of SARS-CoV-2 infection as a possible risk factor for the onset of GCA and its ocular manifestations, such as AAION. However, further research is needed to determine the relationship between SARS-CoV-2 infection and GCA. Because some symptoms of the 2 diseases are similar, the diagnosing process might be long and challenging. The diagnosis of GCA should be made as soon as possible to avoid serious complications, such as bilateral vision loss.
Diabetes has been declared an epidemic of the XXIst century by the World Health Organisation. Diabetic retinopathy, one of its main complications, is a leading cause of vision impairment among professionally active adults. Diabetic retinopathy is a microangiopathy that affects mainly small vessels, due to their highest vulnerability to hyperglycemia. Preventive measures involve mainly strict diabetic follow-ups, balanced level of glycated hemoglobin, blood pressure values and analysis of lipids. Regular ophthalmological check-ups and imaging tests of the retina are also extremely significant. For many years scientists have searched for a therapy to suppress vascular changes in diabetes. In May 2021 a stance on sulodexide use as a supporting treatment in mild and intermediate diabetic retinopathy was published by the Polish Society of Ophthalmology. Sulodexide protects vascular endothelium, contributes to endothelial cells’ function and has profibrinolytic, anti-inflammatory and vasoregulatory properties. These features make it a promising protective agent in the early stages of diabetic retinopathy.
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