Pachychoroid Spectrum Disorder Findings in Patients with Coronavirus Disease 2019

Abstract

Purpose. To report the occurrence of acute, bilateral, central serous chorioretinopathy (CSC), and pachychoroid spectrum disorder findings in patients with coronavirus disease 2019 (COVID-19). Methods. In recovered cases of COVID-19 with visual disturbances, complete ocular examinations with multimodal retinal and choroidal evaluation, including enhanced depth imaging optical coherence tomography, fluorescein or indocyanine green angiography, and blue autofluorescence, were obtained. Results. Four COVID-19 recovered patients presented with bilateral blurred vision. Ocular examination and imaging revealed pachychoroid and pachyvessels associated with choroidal hyperpermeability without any obvious intraocular inflammation. Bilateral localized serous retinal detachment was obvious in three cases compatible with pachychoroid associated with CSC manifestation and pachychoroid pigment epitheliopathy in one patient. CSC was resolved with treatment by steroidal antimineralocorticoid (Eplerenone) in two patients and by photodynamic therapy in one patient. None of the patients reported emotional stress and history of corticosteroid consumption. Conclusion. Hyperpermeability of the choroid, pachychoroidopathy, or choroidal vessel congestion can be observed or exacerbated in association with COVID-19.

Case series bacillary layer detachment associated with acute central serous chorioretinopathy in patients with COVID-19

“…In the first report, all three cases improved after treatment, two cases with steroidal anti mineralocorticoid and one case by photodynamic therapy. 22 In the second article, the patient improved without treatment. 23…”

“…Few previously reported studies have described the development of CSC in COVID-19. Abrishami et al reported three cases of bilateral CSC 22 and Amulya and Thanuja one unilateral case, 23 all not associated with corticosteroid use. In the first report, all three cases improved after treatment, two cases with steroidal anti mineralocorticoid and one case by photodynamic therapy.…”

“… 27 In all of these cases, subretinal fluid was observed but without fibrin formation or subretinal fibrin material (SRFM). 22 , 23 , 24 , 25 , 26 , 27 …”

Combined retinal and choroidal microvasculopathy in a non-diabetic kidney transplant recipient following SARS-CoV-2 infection

“…These vessels may have a direct impact on outer retina perfusion by mechanically compressing inner choroidal layers and inducing choriocapillaris ischemia as seen on indocyanine angiography imaging. Pachychoroid phenotype with hyperpermeability and congestion of the choroidal vasculature can be observed or exacerbated in the setting of COVID-19 [25].…”

Changes in Anterior Chamber Parameters Measured by Pentacam in Coronavirus Disease 2019 Infection: A Longitudinal Study

“…Ocular surface, as well as corneal signs and symptoms, was reported, and the most prevalent manifestations were conjunctivitis and dry eye [ 2 , 3 ]. Posterior segment involvements were numerous as cotton wool spots, retinal hemorrhages, dilated and tortuous vessels, decreased retinal microvasculature, ischemic retinal involvements, pachychoroid spectrum presentations, chorioretinitis, and optic nerve head involvement [ 4 – 7 ]. Furthermore, neuroinvasive actions of the virus were reported in previous studies [ 8 , 9 ].…”