Multitarget microangiopathy in a young healthy man with COVID-19 disease: A case report

Abstract

A 41-year-old man presented to the emergency department complaining of decrease of vision in his left eye. Initial examination was consistent with retrobulbar optic neuritis, and an intravenous drip of methylprednisolone was started. On the third day, the fundus examination revealed the appearance of multiple Purtscher-like cotton-wool spots in the posterior pole and nasally to the optic disc, slight retinal whitening around the fovea, and cherry-red spot. The patient reported flu-like symptoms, and he tested positive at PCR (polymerase chain reaction) test for 2019-nCoV (2019 novel coronavirus) infection. Assuming possible 2019-nCoV-related vascular damage, we prescribed low-molecular-weight heparin. The lesions were regressing at follow-up, and we registered a complete visual recovery.

Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy during SARS-CoV-2 Infection and Vaccination

“…PAMM was more commonly seen in patients with COVID-19 infections ( n = 10) than in patients following vaccinations ( n = 4). PAMM was associated with central retinal artery occlusion (CRAO) in two patients with COVID-19 infection and in one patient with cilioretinal artery occlusion [ 8 , 9 , 10 ]. Turedi and Onal Gunay described the case of a 54-year-old male who developed CRAO two weeks following COVID-19 infection [ 8 ].…”

“…After three days, the patient developed Purtscher-like retinopathy, and a diagnosis of atypical CRAO was considered. OCT of the left eye revealed a PAMM lesion in this patient [ 9 ]. Subsequently, the patient tested positive at PCR for COVID-19 infection after he developed flu-like symptoms [ 9 ].…”

“…OCT of the left eye revealed a PAMM lesion in this patient [ 9 ]. Subsequently, the patient tested positive at PCR for COVID-19 infection after he developed flu-like symptoms [ 9 ]. Two patients had combined features of AMN and PAMM in patients with the COVID-19 infected group, whereas one such case was reported in a vaccinated patient [ 11 , 12 , 13 ].…”

Bilateral Purtscher-Like Retinopathy Associated With COVID-19 Infection

“…To our knowledge, this is one of only a few cases reported of Purtscher-like retinopathy secondary to COVID-19 infection. Similar presentations have been described in patients with severe COVID-19 infections requiring hospitalization and intubation and 1 case has been reported with mild symptoms like this patient. Although the temporal association of this finding with the COVID-19 infection suggests a cause-and-effect relationship, one cannot determine with certainty that the findings were due to COVID-19, or some other confounding event associated with the infection.…”

Retinal microvascular changes in patients recovered from COVID-19 compared to healthy controls: A meta-analysis

“…Most of the clinical manifestations of the disease involve the respiratory tract, however extrapulmonary symptoms have been also identified. According to a recent meta-analysis, ocular manifestations of COVID-19 infection have been found to involve 11% of the infected population [2] , including complications of both the anterior and posterior segment of the eye [3] , [4] , [5] .…”