Non-arteritic anterior ischaemic optic neuropathy sequential to SARS-CoV-2 virus pneumonia: preventable by endothelial protection?

Abstract

We present a case of non-arteritic anterior ischaemic optic neuropathy (NAION) with no ocular or systemic risk factors in a patient who recovered from a recent SARS-CoV-2 pneumonia. NAION is the most common acute optic neuropathy among individuals over 50 years of age. It results from a transient hypoperfusion of the optic nerve head circulation, especially in patients with low vascular compliance due to ocular or systemic risk factors. We attribute the ophthalmological condition to a SARS-CoV-2 virus-associated endotheliopathy that can be prevented with timely protection of endothelial function with vitamins D and K2.

Non-arteritic anterior ischemic optic neuropathy in COVID-19 infection – A case report

“… COVID-19 vaccination-related vasculopathy on the microvascular network of the optic nerve head. 16 5 Moschetta L et al 17 64 year old Caucasian male with no ocular or systemic risk factors for NAION who had SARS-CoV-2 pneumonia 4 weeks back. SARS-CoV2 related endotheliopathy.…”

“… SARS-CoV2 related endotheliopathy. 17 6 Yuksel B et al 18 72-year-old male dentist, smoker, and a known case of Diabetes Mellitus, Hypertension, and Ulcerative Colitis, under medications, who was diagnosed as progressive NAION 13 days after testing positive for SARS CoV2. Disturbances in endothelial cells that and reduced fibrinolysis leads to the hypercoagulability and thrombosis formation within the arterioles supplying the optic nerve leading to ischemia.…”

A case of endogenous candida endophthalmitis with incidental cytomegalovirus infection and optic neuropathy in a patient recovered from severe COVID-19

“…There are some reported cases of NAAION in post COVID-19 patients, which explains the possibility of endotheliopathy and transient hypoperfusion of peripapillary microcirculation. [ 6 ]…”

Non-arteritic anterior ischaemic optic neuropathy (NA-AION) and COVID-19 vaccination

“…Ischaemic optic neuropathy has also been reported with SARS-CoV-2 infection. SARS-CoV-2-associated endotheliopathy could be the likely hypothesis for this 37. Prone positioning which has been recommended for COVID-19 patients for improving oxygen saturation in lungs, could also play a role in causing NA-AION 38.…”