Hemi- and Central Retinal Vein Occlusion Associated with COVID-19 Infection in Young Patients without Known Risk Factors

Ashkenazy, Noy; Patel, Nimesh; Sridhar, Jayanth; Yannuzzi, Nicolas A.; Belin, Peter J.; Kaplan, Richard; Kothari, Nikisha; Bajandas, Gabriel A Benitez; Kohly, Radha P.; Roizenblatt, Roberto; Pinhas, Alexander; Mundae, Rusdeep; Rosen, Richard B.; Ryan, Edwin H.; Chiang, Allen; Chang, L. L.; Khurana, Rahul N.; Finn, Arthur L.

doi:10.1016/j.oret.2022.02.004

Cited by 15 publications

(7 citation statements)

References 60 publications

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“…Two possible mechanisms have been proposed to explain vascular damage in COVID-19 disease affecting either arterial or venous circulation. First, a hypercoagulable state might result from direct viral-mediated endothelial damage [ 28 ]. In fact, the virus invades into the cell through the ACE2 receptor and activates the renin-angiotensin system (RAS) [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

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Pathogenesis of Vascular Retinal Manifestations in COVID-19 Patients: A Review

2022

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Pandemic infection secondary to coronavirus disease 2019 (COVID-19) had an important impact on the general population affecting not only respiratory tract but also many other organs. Ocular manifestations are quite common at the level of the anterior segment (conjunctivitis, dry eye), while posterior segment and, in particular, retinal findings are less frequent. In the retina, COVID-19 is associated with vascular events. Since retinal arteries and veins represent an accessible window to the microvasculature of the rest of the body, a better understanding of the profile of retinal vascular occlusive events may help elucidate mechanisms of thrombo-occlusive complications in other organs in patients affected by COVID-19. In this review, we conducted a systematic literature search focused on retinal arterial and/or retinal venous manifestations. Twenty-one studies were included, describing a wide range of manifestations from mild signs like cotton wool spots, focal and flame-shaped hemorrhages, and vein dilation to more severe retinal artery and vein occlusions. Two principal pathogenetic mechanisms are considered responsible for these complications: a hypercoagulative state and a massive inflammatory response leading to a disseminated intravascular coagulation-like syndrome.

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Section: Discussionmentioning

confidence: 99%

“…Eight presented CRVO, 1 hemiretinal RVO, 3 BRVO, and 2 CRAO. Recently, Ashkenazy et al [ 28 ] reported a case series of 12 patients that developed CRVO (9 of 12 eyes) or HRVO (3 of 12 eyes) after COVID-19 infection. Three patients were hospitalized but not intubated.…”

Section: Retinal Findings In Covid-19 Patientsmentioning

confidence: 99%

Pathogenesis of Vascular Retinal Manifestations in COVID-19 Patients: A Review

2022

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“…In case of COVID-19 vaccination, vaccine-induced immune thrombotic thrombocytopenia (VITT), which can lead to cerebral venous sinus thrombosis, has been found to be particularly associated with the adenovirus vector-based COVID-19 vaccines [234] , [235] , [236] , [237] , [238] , [239] , [240] , [241] , [242] . Another example are retinal artery/vein occlusions induced by SARS-CoV-2 infection [243] , [244] , [245] , [246] , [247] , [248] , [249] , [250] , [251] , [252] , [253] , [254] , [255] , [256] , [257] , [258] , [259] , [260] , [261] , [262] and COVID-19 vaccination [263] , [264] , [265] , [266] , [267] , [268] , [269] , [270] , [271] , [272] , [273] , [274] , [275] , [276] , [277] , [278] , [279] , [280] , [281] , [282] , [283] , [284] , [285] , [286] , [287] , [288] , [289] , [290] , [291] , [292] , which can thus can be considered part of the symptoms of COVID-19 and PCVS. Noteworthy, induced retinal artery/vein occlusions induced COVID-19 vaccination were found to be “more common than anticipated” [263] .…”

Section: Sars-cov-2 Infection- and Covid-19 Vaccination-induced Syndr...mentioning

confidence: 99%

COVID-19, post-acute COVID-19 syndrome (PACS, “long COVID”) and post-COVID-19 vaccination syndrome (PCVS, “post-COVIDvac-syndrome”): Similarities and differences

Scholkmann

May

2023

Pathology - Research and Practice

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“…A study by Bertram et al shows that RVO in young patients was significantly correlated with protein C, protein S, and antithrombin deficiency [37]; however, other authors have failed [40,41]. Association between pseudotumor cerebri and CRVO in young patients has been previously reported [7].…”

Section: Etiological Differencesmentioning

confidence: 99%

Clinical Features of Central Retinal Vein Occlusion in Young Patients

et al. 2022

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Retinal vein occlusion (RVO) is the second most common retinal vascular disease. Central RVO (CRVO), in which obstruction occurs posterior to the lamina cribrosa due to various causes, manifests with extensive venous tortuosity, dilatation of blood vessels in the four quadrants, and retinal hemorrhage. The presence of macular edema decreases visual acuity in patients with CRVO, especially in elderly patients with hypertension, hyperlipidemia, and diabetes. In the last decade, treatment modalities for CRVO have improved, with antivascular endothelial growth factor agents being widely used as treatment. However, there are cases of refractory or recurrent macular edema. Moreover, CRVO also occurs in young patients. This article reviews previous studies and case reports and summarizes the differences in etiological factors, clinical manifestations, treatment, and prognosis between young and elderly patients. Due to the low incidence of CRVO in young patients, clinical data from these age groups are limited. Hence, further studies are warranted to explore the differences between age groups to improve individualization of treatment of young patients.

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Hemi- and Central Retinal Vein Occlusion Associated with COVID-19 Infection in Young Patients without Known Risk Factors

Cited by 15 publications

References 60 publications

Pathogenesis of Vascular Retinal Manifestations in COVID-19 Patients: A Review

Pathogenesis of Vascular Retinal Manifestations in COVID-19 Patients: A Review

COVID-19, post-acute COVID-19 syndrome (PACS, “long COVID”) and post-COVID-19 vaccination syndrome (PCVS, “post-COVIDvac-syndrome”): Similarities and differences

Clinical Features of Central Retinal Vein Occlusion in Young Patients

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