Covid-19-Associated Retinopathy: A Case Report

Gascon, Pierre; Briantais, Antoine; Bertrand, Emmanuelle; Ramtohul, Prithvi; Comet, Alban; Beylerian, Marie; Sauvan, Lauren; Swiader, L.; Durand, J.-M.; Denis, D.

doi:10.1080/09273948.2020.1825751

Cited by 108 publications

(109 citation statements)

References 23 publications

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“…Recently, Virgo and Mohamed in two cases reported PAMM and AMN in recovered COVID-19 patients [11]. In another report, a patient with visual loss during acute SARS-CoV-2 infection was found to have Roth's spot, and both AMN and PAMM lesions [12]. This patient was very similar to our patient, as he had also Roth's spots beside AMN.…”

Section: Discussionsupporting

confidence: 80%

Acute macular neuroretinopathy in a patient with acute myeloid leukemia and deceased by COVID-19: a case report

Zamani

Azimi

Aminizadeh

et al. 2020

J Ophthal Inflamm Infect

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Purpose Acute macular neuroretinopathy (AMN) is a visual-deteriorating rare clinical entity with an uncertain etiology. We aimed to report a case of AMN and underlying disease of acute myeloid leukemia (AML). Case presentation A thirty-five-year-old female patient with bone marrow biopsy confirmed AML, and bicytopenia, under chemotherapy, complained of sudden paracentral visual field defect in her right eye was referred. Visual acuity was 20/20 in both eyes. Posterior segment evaluation revealed multiple Roth’s spots. Optical coherence tomography (OCT) demonstrated hyper-reflectivity band, in the outer nuclear layer and outer plexiform layer, nasal to the fovea of the right eye, and hyperreflective patch in outer retina segmentation en-face OCT, suggestive of the diagnosis of AMN. Nine days after AMN diagnosis, dyspnea, malaise, and cough was initiated. Ground glass opacities in lung CT scan, beside reverse transcription polymerase chain reaction of severe acute respiratory syndrome coronavirus-2, was conclusive of coronavirus disease 2019 (COVID-19). The patient deceased after 6 days. Conclusion We report a rare case of AMN following AML. Our findings support the role of ischemia in the outer retina, of which AML may contributed to the pathophysiological process. The patient has deceased less than 2 weeks from AMN initiation.

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Section: Discussionsupporting

confidence: 80%

Acute macular neuroretinopathy in a patient with acute myeloid leukemia and deceased by COVID-19: a case report

Zamani

Azimi

Aminizadeh

et al. 2020

J Ophthal Inflamm Infect

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“…Our scienti c understanding of thefactors involved in SARS-CoV-2 viral transmission and a nity for multiple human host cell targets continues to evolve. There isnow an expanding list of documented impairmentsof the human visual systemand multiple types of visual dysfunction and/or vision de ciency associated with COVID-19 infection [15][16][17][18][19][20][21][22][23][24][25]46,[51][52][53][60][61][62][63]. The current study provides new insight into the distribution of the ACE2 receptor in eye and brain cells and tissues involved in visual signal processing.The ACE2 receptor is acknowledged as the major molecular receptor for SARS-CoV-2, and speci c anatomical regions of the eye and the visual circuitry of the brain contain abundantly detectable ACE2 receptor mRNA and protein.…”

Section: Discussionmentioning

confidence: 98%

“…811 nucleotides the unusually large SARS-CoV-2 virus possesses an enveloped, positive-stranded ssRNA genome that shares signi cant homology to previously described SARS-CoV and themiddle east respiratory syndrome coronavirus (MERS-CoV)[40][41][42].SARS-CoV-2 has an extremely high a nity for a ubiquitous 92.5 kDa, zinc-containing, membrane-integral ACE2 cell surface receptor (EC 3.4.17.23). SARS-CoV-2-ACE2binding results in the endocytosis and translocation of both SARS-CoV-2 and the ACE2 receptor into the endosomes of infected cells[5,7,9,22,[43][44][45][46][47]. Other ACE2-associated proteins such as the serine protease 2 TMPRSS2 (epitheliasin; EC 3.4.21.109) may facilitate SARS-CoV-2 entry[11,43,48].…”

mentioning

confidence: 99%

Angiotensin Converting Enzyme 2 (ACE2) Expression in the Visual System

Hill

Clément

Arceneaux

et al. 2021

Preprint

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Background: Multiple lines of evidence currently indicate that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)gains entry into human host cells via a high-affinity interaction with the angiotensin-converting enzyme 2 (ACE2) transmembrane receptor. Research has further shown the widespread expression of the ACE2 receptor on the surface of many different immune, non-immune and neural host cell types, and that SARS-CoV-2 has there markable capability to attack many different types of human-host cells simultaneously. One principal neuroanatomical region for highACE2 expression patterns occurs in the brainstem, an area of the brain containing regulatory centers for respiration, and this may in part explain the predisposition of many COVID-19 patients to respiratory distress. Early studies also indicated extensive ACE2 expression in the whole eye and the brain’s visual circuitry. In this study we analyzed ACE2 receptor expression at the mRNA and protein level in multiple cell types involved in human vision, including cell types of the external eye and several deep brain regions known to be involved in the processing of visual signals.Methods: ACE2 mRNA and protein analysis; multiple eye and brain cells and tissues; gamma32P-adenosine tri-phosphate ([γ-32P]dATP) radiolabeled probes; Northern analysis; ELISA.Results: The four main findings were: (i)that many different optical and neural cell types of the human visual system provide receptors essential for SARS-CoV-2 invasion; (ii)the remarkable ubiquity of ACE2 presence in cells of the eye and anatomical regions of the brain involved in visual signal processing; (iii)that ACE2 receptor expression in different ocular cell types and visual processing centers of the brain provide multiple compartments for SARS-CoV-2 infiltration; and (iv)a gradient of increasing ACE2 expression from the anterior surface of the eye to the visual signal processing areas of the occipital lobe and the primary visual neocortex.Conclusion: A gradient of ACE2 expression from the eye surface to the occipital lobe provide the SARS-CoV-2 virus a novel pathway from the outer eye into deeper anatomical regions of the brain involved in vision. These findings may explain, in part, the many recently reported neuro-ophthalmic manifestations of SARS-CoV-2infection in COVID-19 affected patients.

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“…Increased venular tortuosity and dilation has also been observed 110 . Other ocular ischaemic changes recently reported in this context include papillophlebitis, 113 paracentral acute middle maculopathy or acute macular neuroretinopathy 114,115 and impending central retinal vein occlusion 116 …”

Section: Implications For the Ophthalmologistmentioning

confidence: 89%