Unilateral Optic Neuritis as the First and Only Manifestation of SARS-CoV-2 Infection

Giacuzzo, Clarice; Kawasaki, Aki

doi:10.1055/a-1771-6519

Cited by 3 publications

(3 citation statements)

References 12 publications

(18 reference statements)

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“…The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow chart is shown in figure 1. There were 34 studies of ON following COVID-19 infection,12–45 and an equal number of publications reported patients with ON post-COVID-19 vaccination 46–78. There were 19 case series and the remaining 49 were case reports.…”

Section: Resultsmentioning

confidence: 99%

Systematic review exploring the clinical features of optic neuritis after SARS-CoV infection and vaccination

Georganta,

Chasapi,

Smith

et al. 2023

BMJ Open Ophth

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BackgroundThis study aims to characterise the symptoms and clinical features of optic neuritis (ON) following SARS-CoV-2 infection and vaccination.MethodA literature search was conducted in four databases (PubMed, Medline, Embase and Google Scholar) to identify relevant case reports and case series. The records were screened and articles adhering to the inclusion criteria were critically appraised.ResultsSixty-eight studies were found to be eligible for inclusion, including 34 reporting ON following SARS-CoV-2 infection and an equal number reporting cases postvaccination. In total 93 patients and 125 eyes were included. The infection cohort included 42 patients and 56 eyes, 51.2% were female and 33.3% experienced bilateral ON. The mean visual acuity was 1.64 log of minimum angle of resolution (LogMAR), while pain was present in 77.8%. Oligoclonal bands were present in 3 patients, myelin oligodendrocyte glycoprotein (MOG) antibodies in 18 patients and AQP-4 antibodies in 4 patients. The vaccination cohort included 51 patients and 69 eyes. 60.8% were female and 35.3% had a bilateral ON. The mean visual acuity was 0.93 LogMAR. Oligoclonal bands were present in 46.7%, MOG antibodies in nine patients and AQP-4 antibodies in three patients.ConclusionPatients with ON post-SARS-CoV infection were more likely to experience severe visual impairment than in cases following vaccination. Further research is required to outline the clinical features of ON after COVID-19 infection and vaccination, and establish causality.

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Section: Resultsmentioning

confidence: 99%

Systematic review exploring the clinical features of optic neuritis after SARS-CoV infection and vaccination

Georganta,

Chasapi,

Smith

et al. 2023

BMJ Open Ophth

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“…It is known that patients with advanced COVID-19 disease who are in a prone position to improve oxygenation for extended periods are at risk of developing orbital compartment syndrome. These patients may develop periorbital edema, optic disc edema, retinal hemorrhages, central retinal artery occlusion, central retinal vein occlusion, and ischemic optic neuropathy 31 , 32 , 33 .…”

Section: Discussionmentioning

confidence: 99%

Retinal Findings in Hospitalized COVID-19 Patients, Is Routine Ophthalmological Examination Required after Discharge? Prospective Case-Control Study

Akalin

Kalkişim

Günay

et al. 2023

Klin Monbl Augenheilkd

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Objectives To investigate retinal findings by comparing patients hospitalized for COVID-19 with the control group. Methods In this prospective study, 188 eyes of 94 recovered COVID-19 patients and 108 eyes of 54 healthy participants as a control group were evaluated. Patients were divided into three groups, those with mild, moderate, and severe COVID-19. Refractometry, tonometry, optical biometry, optical coherence tomography (OCT) measurements, and complete ophthalmological examinations were performed on healthy volunteers and COVID-19 patients on average 2 weeks after discharge. Pulse O2 and vital parameters were also assessed. Primary outcomes were evaluated, such as retinal findings, and secondary outcomes as retinal thickness, choroidal thickness (CT), retinal nerve fiber layer thickness, and ganglion cell layer thickness. Results There was no difference between the groups in terms of demographic data, ocular biometry, and intraocular pressure (p > 0.05). Pulse O2 was lower in the study group (p < 0.001). Retinal findings were detected in 68 (36.1%) of 188 eyes in the study group and 28 (25.9%) of 108 eyes in the control group (p = 0.07). The two most common retinal findings were hypertensive retinopathy and retinal pigment epithelium alterations and/or drusen in both groups. In OCT measurements, significant thinning was observed in nasal macular thickness and superior 2 mm CT in the study group compared to the control group (p < 0.05). In patients divided into subgroups according to disease severity, no significant difference was found between the groups in any OCT parameter (p > 0.05). Conclusion It has been observed that COVID-19 infection does not cause a specific and sensitive finding in the ocular tissues, especially the retina, and does not produce a reproducible measurement result. Recommending routine eye exam after COVID-19 does not seem cost-effective.

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“…This presentation was interpreted as a case of post-COVID-19 MS. A 55-year-old woman was reported with ON with optic nerve enhancement and positive oligoclonal bands who was found to have COVID-19 pneumonia, presumably from MS. 32 While some cases of ON followed severe COVID-19 requiring intensive care unit (ICU) admission for severe COVID-19 complications, 33 other cases have been described in the setting of asymptomatic or minimally symptomatic infection. 34,35 One case has been described in association with a previous facial nerve palsy. 36 Radiological evidence of ON in the literature is variable.…”

Section: Optic Neuritismentioning

confidence: 99%

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

Dinkin

Sathi

2023

Semin Neurol

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We set out to describe in detail the afferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, new variants of COVID-19 continue to pose an international threat, and patients with rare neuro-ophthalmic complications are likely to continue to present for care.Afferent complications from COVID-19 include homonymous visual field loss, with or without higher cortical visual syndromes, resulting from stroke, intracerebral hemorrhage, or posterior reversible leukoencephalopathy. Optic neuritis has frequently been reported, sometimes along with acute disseminated encephalomyelopathy, often in association with either myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) or less commonly aquaporin-4 seropositivity or in newly diagnosed multiple sclerosis. Ischemic optic neuropathy has rarely been reported. Papilledema, resulting either from venous sinus thrombosis or idiopathic intracranial hypertension in the setting of COVID-19, has also been described.Observed afferent neuro-ophthalmic associations need to be confirmed though larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.

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Unilateral Optic Neuritis as the First and Only Manifestation of SARS-CoV-2 Infection

Cited by 3 publications

References 12 publications

Systematic review exploring the clinical features of optic neuritis after SARS-CoV infection and vaccination

Systematic review exploring the clinical features of optic neuritis after SARS-CoV infection and vaccination

Retinal Findings in Hospitalized COVID-19 Patients, Is Routine Ophthalmological Examination Required after Discharge? Prospective Case-Control Study

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

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