A case of retinal vascular involvement in a 6-year-old patient with Covid-19

Abbinante, Giulia; Plaitano, Carmen; Gallo, Flavio Gioele; Magli, Adriano

doi:10.1177/11206721211027069

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Kulkarni et al presented a case of combined central retinal artery and vein occlusion (CRVO) in a 20-year-old boy [ 9 ]. For what concerns pediatric population, retinal vasculitis has been described in a child five months after an asymptomatic SARS-CoV-2 infection [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Central retinal artery occlusion in a young child affected by COVID-19: a first case report

Abbati,

Fazi,

Fortunato

et al. 2023

BMC Pediatr

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Background Central retinal artery occlusion (CRAO) is an ophthalmic emergency, and its etiology is generally ascribed to vessel occlusion by a thrombus or embolus, eventually due to a hypercoagulable state. CRAO occurrence is described even in the pediatric population, but its incidence is very rare. SARS-CoV-2 infection has a multitude of presentations, and almost any organ may be involved including the ocular district. Cases of CRAO in patients affected by COVID-19 are reported in the literature in the adult population, but not in the pediatric one. Case presentation We describe the case of a six-year-old otherwise healthy girl, who presented a sudden and complete bilateral vision loss after a one-day fever. All the clinical, ophthalmological, laboratory and instrumental investigations led to the diagnosis of a right CRAO and the suspicion of a contralateral posterior optic nerve affection. These manifestations could not be ascribed to any etiological condition apart from the documented ongoing mild SARS-CoV-2 infection. Treatment with anticoagulants and steroids was tried but the visual outcome was poor during the one-month hospitalization and at the last follow-up. Conclusions To the best of our knowledge, this is the first report of CRAO in the course of SARS-CoV-2 infection in the pediatric age. In our review of the literature, we found few cases of CRAO in adults with COVID-19; we highlighted differences in anamnestic, clinical, and interventional aspects and therefore we tried to summarize the state of the art on this topic to facilitate further studies. Even if rare, the prognosis of CRAO is poor and the thrombolytic treatment could be effective only if rapidly administered, so the disease suspicion should be high in a patient with sudden vision loss, also in pediatric age.

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Section: Discussionmentioning

confidence: 99%

Central retinal artery occlusion in a young child affected by COVID-19: a first case report

Abbati,

Fazi,

Fortunato

et al. 2023

BMC Pediatr

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“…Final VA not reported. Abbinante et al 88 1 (M) 6 No symptoms "No change from baseline" 5 months Unremarkable No OCT, OCTA CWS, vascular tortuosity Observation Unchanged fundus exam Patnaik et al 89 1 (F) 37 Mild OD: 20/20 OS: 20/60 10 days Unremarkable Yes, negative OCT CWS, macular star with subretinal fluid, hemorrhage Observation Complete resolution Gonzalez-Lopez et al 90 1 (M) 50 Moderate 20/20 13 days Unremarkable No OCT, OCTA CWS, arterial nicking HCQ, lopinavir, ritonavir, systemic steroids VA 20/20, improved scotoma Hosseini et al 91 1 (M) 37 Mild OU: CF 4 weeks Unremarkable No OCT, FA Neuroretinitis and panuveitis IVI ganciclovir, topical steroids, and cycloplegic Ayachit et al 92 17 (M = 10, F = 7) 36.57 ± 11.78 Mild logMAR 0.97 ± 0.43 25.96 ± 4.36 days Not reported No …”

Section: Methodsmentioning

confidence: 99%

The spectrum of COVID-19-associated chorioretinal vasculopathy

Carletti,

Shah,

Bair

et al. 2023

American Journal of Ophthalmology Case Reports

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“…Abbinante et al also reported retinal changes that persisted during follow-up without any visual complaints. 36 These changes were vascular tortuosity, especially arterial vasculature, and cotton wool spots along the vessels visible on examination and ancillary tests such as OCT and angio-OCT. Retinal vasculitis was discovered because of vigilance to the potential thromboembolic risk of COVID-19.…”

Section: Retinal Changesmentioning

confidence: 99%

Ocular manifestations of COVID-19 in the pediatric age group

Alnahdi

Alkharashi

2022

European Journal of Ophthalmology

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The coronavirus disease 2019 (COVID-19) is now known to be associated with several ocular manifestations. The literature thoroughly discussed those that affect adults, with a lesser focus in the pediatric age group. We aim to outline the various pediatric ocular manifestations described in the literature. The manifestations may be divided into isolated events attributed to COVID-19 or occurring in the new multisystem inflammatory syndrome in children (MIS-C), a novel entity associated by COVID-19 infection. Ocular manifestations have virtually affected all ages. They manifested in neonates, infants, children, and adolescents. Episcleritis, conjunctivitis, optic neuritis, cranial nerve palsies, retinal vein occlusion, retinal vasculitis, retinal changes, orbital myositis, orbital cellulitis were reported in the literature with this emerging viral illness. Conjunctivitis was the most common ocular manifestation in MIS-C in nearly half of the patients. Other ocular manifestations in MIS-C were anterior uveitis, corneal epitheliopathy, optic neuritis, idiopathic intracranial hypertension, and retinitis. The clinical outcome was favorable, and children regain their visual ability with minimal or no deficits in most of the cases. Further follow-up may be warranted to better understand the long-term effects and visual prognosis.

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A case of retinal vascular involvement in a 6-year-old patient with Covid-19

Cited by 5 publications

References 13 publications

Central retinal artery occlusion in a young child affected by COVID-19: a first case report

Central retinal artery occlusion in a young child affected by COVID-19: a first case report

The spectrum of COVID-19-associated chorioretinal vasculopathy

Ocular manifestations of COVID-19 in the pediatric age group

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