Central retinal artery occlusion in a patient who contracted COVID-19 and review of similar cases

Abstract

A 54-year-old male patient applied to our clinic with a sudden and painless loss of vision in his right eye. He was suffering from COVID-19. His best-corrected visual acuity of the right eye was finger counting from 30 cm. The fundus examination revealed the presence of a ‘cherry-red spot’ appearance in the right eye. In optical coherence tomography imaging, hyper-reflectivity was observed in the inner retinal layers as well as increased retinal thickness in the right eye. In fundus fluorescein angiography, delayed arterial filling and prolonged arteriovenous transit time were observed in the right eye. The patient was diagnosed with central retinal artery occlusion after the COVID-19 infection. In this study, we report this case and its management.

A rare case of external ear canal stenosis caused by COVID-19-related arterial thrombosis

“… 12 Central retinal artery occlusion has also been reported in COVID-19 patients. 13 Thrombosis of superficial veins has also been reported. 14 , 15 These venous thromboses have sometimes been observed as superficial thrombophlebitis.…”

COVID-19-associated mixed cilioretinal artery occlusion and central venous occlusion in a fit and healthy young patient

“…This more insidious presentation is less commonly reported, and although incidental finding of this retinal appearance with COVID-19 infection has to be considered, there are other reports of similar scenarios in young patients. 2 …”

“…There have been several case reports and reviews in the literature of this condition associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. 1 , 2 …”

How Does SARS-CoV-2 Affect Our Eyes—What Have We Learnt So Far about the Ophthalmic Manifestations of COVID-19?

“…So far, only four retinal artery occlusions associated with COVID-19 have been reported [ 45 ]. One of them was the case of a 60-year-old male with hypertension, dyslipidemia, stable coronary artery disease, and chronic obstructive pulmonary disease, who, on the 12th day of hospital admission due to COVID-19 (confirmed by nasopharyngeal PCR), presented a sudden and painless decrease in vision in his right eye [ 46 ].…”

“…Only one patient, a 54-year-old male, did not have a history of hospitalization or ICU stay and did not have any underlying diseases. The period of onset of COVID-19 until a diagnosis of CRAO was 3 weeks [ 45 ]. The authors related the hypercoagulable state of the patient, produced by the inflammation attributable to SARS-CoV-2, with the ophthalmological complication, being consistent with other vascular complications described in the literature, such as ictus or pulmonary embolism [ 49 ].…”