Central retinal vein occlusion in a young healthy COVID-19 patient: A case report

Abstract

Purpose: We detail a unique case of a healthy 33-year-old suspected COVID-19 patient who presented with unilateral Central Retinal Vein Occlusion, possibly as a complication of COVID-19.

Observations: A 33-year-old healthy male was referred to the emergency department due to blurred vision in his left eye for the past month, accompanied by flashes of light without any accompanying neurological symptoms. The patient reported a three-week period of fatigue, dry cough, and shortness of breath ended about 2 weeks prior to the ocular symptoms. He was not tested for COVID-19 at the time of his respiratory complaints.The clinical examination and the ancillary tests confirmed the diagnosis of a left eye Central Retinal Vein Occlusion.During admission, a real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 from a nasopharyngeal swab was performed and was found to be negative, however, an IgG/IgM Rapid Test (Inzek International Trading, the Netherlands) was performed and was found to be IgM negative and IgG Positive for SARS-CoV-2, confirming recovery from COVID-19.

Conclusions and importance: To the best of our knowledge this is the first report of CRVO in association with COVID-19.As the literature on human ocular manifestations of COVID-19 is still sparse, our case emphasizes the need for further investigation of ocular complication associated with this novel disease.

Keywords: COVID-19; CRVO; Central retinal vein oclusion.

Fig. 1

A- Fundus photography of the left eye showing tortuosity and dilatation of all branches of the central retinal vein, dot, blot and flame-shaped hemorrhages throughout all four quadrants, and optic disc edema. B- Optical Coherence Tomography (OCT) of the macula was within normal limits.

Fig. 2

A- Fluorescein angiography of the left eye in 19 seconds showing marked delay in arteriovenous transit time, masking by retinal hemorrhages. B- Fluorescein angiography of the left eye in 47 seconds showing marked delay in venous filling, staining of dilated tortuous veins and masking by retinal hemorrhages, optic disc leakage. There isn't evidence of widespread capillary no perfusion areas. All well fit with non ischemic CRVO.