Bilateral macular hemorrhage in a patient with COVID-19

D’Aloisio, Rossella; Nasillo, Vincenzo; Gironi, Matteo; Mastropasqua, Rodolfo

doi:10.1016/j.ajoc.2020.100958

Cited by 16 publications

(18 citation statements)

References 10 publications

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“…D'Aloisio R et al reported a case who developed bilateral retinal hemorrhages, involving the fovea in one patient [ 10 ]. These hemorrhages spontaneously resolved within a month.…”

Section: Resultsmentioning

confidence: 99%

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Retinal manifestations in patients with SARS-CoV-2 infection and pathogenetic implications: a systematic review

et al. 2021

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Introduction The pandemic of COVID-19 has been caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Apart from respiratory malfunction, COVID-19 causes a system-wide thromboembolic state, leading to serious cardiovascular, cerebrovascular and peripheral vascular manifestations. However, our knowledge regarding retinal manifestations due to systemic COVID-19 is minimal. This systematic review has comprehensively summarized all retinal manifestations secondary to COVID-19 disease recorded till date since the beginning of the pandemic. Methods All studies published till November 27, 2020, which have reported retinal manifestations in COVID-19 patients were systematically reviewed using the PRISMA statement. Results We included 15 articles: 11 case reports and four cross-sectional case series. The most commonly reported manifestations which did not affect visual acuity were retinal hemorrhages and cotton wool spots. The most common vision threatening manifestation was retinal vein occlusion with associated macular edema. Rarely, patients may also present with retinal arterial occlusions and ocular inflammation. These manifestations may occur from as soon as within a week after the onset of COVID-19 symptoms to more than 6 weeks after. Conclusion Mostly causing milder disease, COVID-19 may however lead to severe life-threatening thromboembolic complications, and systemic antithrombotic therapy has been suggested as a prophylactic and therapeutic management strategy for patients affected with serious systemic disease. However, both sick and apparently healthy patients may suffer from various retinal complications which may lead to loss of vision as well. No consensus regarding management of retinal complications with anticoagulants or anti-inflammatory medications have been proposed; however, they may be tackled on individual basis.

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“…D'Aloisio R et al reported a case who developed bilateral retinal hemorrhages, involving the fovea in one patient [ 10 ]. These hemorrhages spontaneously resolved within a month.…”

Section: Resultsmentioning

confidence: 99%

“…Authors also noted that fibrinogen, CRP, ferritin and LDH levels were all raised in the patients. D'Aloisio R et al reported a case who developed bilateral retinal hemorrhages, involving the fovea in one patient [10]. These hemorrhages spontaneously resolved within a month.…”

Section: Retinal Hemorrhages and Cotton Wool Spotsmentioning

confidence: 97%

Retinal manifestations in patients with SARS-CoV-2 infection and pathogenetic implications: a systematic review

et al. 2021

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“…A total of 14 case reports, two cross-sectional studies, and two prospective cohorts were included. Consequently, COVID-19 has been associated with several vitreoretinal abnormalities including central retinal vein occlusion (CRVO),[ 19 22 23 30 32 ] central retinal artery occlusion (CRAO),[ 17 ] serpiginous choroiditis,[ 29 ] chorioretinitis,[ 28 ] macular hemorrhage,[ 18 ] acute macular neuroretinopathy (AMN),[ 22 32 ] paracentral acute middle maculopathy (PAMM),[ 22 32 ] vitritis,[ 19 ] acute retinal necrosis (ARN),[ 21 ] and posterior segment anatomical changes[ 24 26 27 28 30 ] Summary of patients' ocular manifestations were listed in [ Table 2 ].…”

Section: Vitreoretinal Abnormalities In Covid-19 Patientsmentioning

confidence: 99%

Vitreoretinal abnormalities in corona virus disease 2019 patients

Sutandi¹,

Lee²

2021

Taiwan Journal of Ophthalmology

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The coronavirus disease 2019 (COVID-19) has become a global pandemic since December 2019. Although COVID-19 primarily affects the respiratory systems, it has become abundantly clear that it involves multiple organs including the heart, kidney, skin, and brain. Neuro-ophthalmic signs and anterior segment inflammation of the eyes were documented in COVID-19 patients recently. Small but growing number of literatures has also reported the cases of new onset vitreoretinal disorders related to COVID-19 infection. A comprehensive search from four online databases was done. Findings show vitreoretinal involvement in COVID-19 patients including the central retinal vein occlusion, central retinal artery occlusion, reactivation of previous uveitis, chorioretinitis, macular hemorrhage, acute macular neuroretinopathy, paracentral acute middle maculopathy, vitritis with outer retinal abnormalities, varicella zoster virus-related acute retinal necrosis in immunocompromised patient, and other posterior segment pathological changes. The hypotheses for potential pathogenesis of these manifestations are direct viral ocular infection and thromboembolic complications secondary to the hyperinflammatory response. This is the first review article, which provides an overview of current evidence regarding the vitreoretinal manifestations in COVID-19 patients.

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“…Prothrombotic state and immune-mediated reactions triggered by COVID-19 infection can lead to retinal damage by endothelial dysfunction, which can cause cotton wool spots, edema and retinal hemorrhage clinically [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19: more than a respiratory virus, an optical coherence tomography study

Şeker¹,

Timur

2021

Int Ophthalmol

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Purpose The purpose of this study is to investigate anatomic and morphologic features of inner and outer retinal layers in patients recovered from COVID-19 with Spectral Domain Optical Coherence Tomography (SD-OCT), whether correlate with any symptoms during disease process. Methods 32 patients recovered from COVID-19 and age- and gender-matched 36 healthy controls were included in this cross-sectional study. Ganglion cell-inner plexiform layer, macular and peripapiller retinal nerve fiber layer (RNFL), inner nuclear layer (INL), outer nuclear layer (ONL), outer plexiform layer (OPL) and the outer retinal hyperreflective bands including external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IZ) were examined with SD-OCT. The differences of each retinal layers thickness among subgroup analysis of ocular pain and headache were also compared. Results Macular RNFL of inner and outer nasal and outer inferior quadrants were thinner in COVID-19 patients compared to healthy control group ( p = 0.046, p = 0.014 and p = 0.016, respectively). Thinning in outer superior quadrant of GCIPL and INL quadrants were detected in patients with headache ( p = 0.026 and p = 0.01). Superonasal and inferotemporal sectors of pRNFL were thinner in patients with ocular pain compared to patients without ocular pain ( p = 0.024 and p = 0.015). Integrity of EZ, ELM and IZ was evaluated as continuous line and protected on each OCT scans. Conclusion The study demonstrated convincing evidence that SARS-CoV-2 can affect the inner and outer retinal layers, with subclinical localized alterations, particularly in patients with headache and ocular pain symptoms during COVID-19 period. Supplementary Information The online version contains supplementary material available at 10.1007/s10792-021-01952-5.

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Bilateral macular hemorrhage in a patient with COVID-19

Cited by 16 publications

References 10 publications

Retinal manifestations in patients with SARS-CoV-2 infection and pathogenetic implications: a systematic review

Retinal manifestations in patients with SARS-CoV-2 infection and pathogenetic implications: a systematic review

Vitreoretinal abnormalities in corona virus disease 2019 patients

COVID-19: more than a respiratory virus, an optical coherence tomography study

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