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Case Reports
. 2020 Dec 23:11:588384.
doi: 10.3389/fphar.2020.588384. eCollection 2020.

Case Report: Central Retinal Artery Occlusion in a COVID-19 Patient

Andrea Montesel  1 , Claudio Bucolo  2 , Victoria Mouvet  1 , Emmanuelle Moret  1 , Chiara M Eandi  1
Affiliations
Case Reports

Case Report: Central Retinal Artery Occlusion in a COVID-19 Patient

Andrea Montesel et al. Front Pharmacol. .

Abstract

We report a case of central retinal artery occlusion (CRAO) in a patient with a previous history of severe COVID-19 disease. This disease has been associated with inflammatory-induced homeostasis changes leading to endothelial dysfunction and a procoagulant state with multi-organ involvement, but the burden of thromboembolic complications in COVID-19 patients is currently unknown. The pathogenesis of retinal artery occlusions is a multifactorial process where inflammation and hypercoagulation state are established risk factors. Even if our experience may represent a coincidental relationship, it is likely that COVID-19 patients could be at risk of developing retinal vascular occlusions. A focused ophthalmological surveillance is advisable to prevent and manage this possible cause of severe vision loss that has an important impact in health care system.

Keywords: SARS-CoV-2; case report; central retinal artery occlusion; coronavirus disease-2019; severe acute respiratory syndrome coronavirus 2; thrombosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Fundus photography of the left eye showing the presence of a pale optic disc, diffuse arterial narrowing, a mild ‘cherry-red spot’ macula and peripheral areas of retinal pigmented epithelium hyperpigmentation (A). IR and SD-OCT acquisition over the macular region of the same eye denoting atrophy of the inner retina layers with loss of foveal depression and temporal macular thinning (B,C) [IR, infrared reflectance, SD-OCT, spectral domain optical coherence tomography].
FIGURE 2
FIGURE 2
Fluorescein angiography of the left eye 5 days after the diagnosis of CRAO showing a delayed arrival of the dye in the eye 43 s after the injection (A), peripheral areas of capillary nonperfusion, arteriovenous anastomoses, and neovascular ‘sea-fans’ 4 min and 22 s after the dye injection (B) [CRAO, central retinal artery occlusion].
FIGURE 3
FIGURE 3
Ganglion cell layer thickness analysis performed with the SD-OCT one month after the arterial occlusion. Within normal limits in the right eye (A) and atrophic in the left eye (B) [SD-OCT, spectral domain optical coherence tomography].
FIGURE 4
FIGURE 4
Case report timeline.
See this image and copyright information in PMC

References

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