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

Abstract

Herein, we report a case of bilateral simultaneous central retinal vein occlusion (CRVO) secondary to coronavirus disease 2019 (COVID-19). A 48-year-old man, with hypertension, type 2 diabetes mellitus, and stage 4 chronic kidney disease, diagnosed with COVID-19 1 month ago presented to the ophthalmology department with blurred vision in both eyes for 2 weeks. Ocular examination revealed a classic clinical presentation of CRVO in both eyes. Optical coherence tomography revealed increased central macular thickness with intraretinal and subretinal fluid in both eyes. Laboratory data revealed elevated D-dimer and C-reactive protein (CRP) levels. The levels of other hypercoagulability markers were normal. The patient received intravitreal anti-vascular endothelial growth factor therapy in both eyes, followed by regular follow-up every month until complete resolution of symptoms and gradual improvement of the retinal vascular appearance. COVID-19 can cause a variety of coagulation abnormalities and thromboembolic complications such as bilateral simultaneous CRVO. Clinicians and patients should be aware of ocular symptoms and presentations that are probably associated with COVID-19.

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

“…A case of bilateral thrombosis of the central retinal vein with elevated levels of D-dimer and C-reactive protein secondary to COVID-19 was also described [48]. Venkatesh R, Reddy NG, Agrawal S, Pereira A. describe a case of COVID-19-associated central retinal vein thrombosis with elevated D-dimer and ESR [49].…”