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Case Reports
. 2022 Jul;32(4):NP1-NP5.
doi: 10.1177/11206721211027069. Epub 2021 Jun 26.

A case of retinal vascular involvement in a 6-year-old patient with Covid-19

Giulia Abbinante  1 , Carmen Plaitano  2 , Flavio Gioele Gallo  1 , Adriano Magli  1
Affiliations
Case Reports

A case of retinal vascular involvement in a 6-year-old patient with Covid-19

Giulia Abbinante et al. Eur J Ophthalmol. 2022 Jul.

Abstract

Purpose: This study evaluated fundus changes in a 6-year-old child who contracted Sars-CoV-2 without developing symptoms of the disease.

Materials and methods: The patient underwent a complete ophthalmic evaluation, which included assessment of visual acuity with and without correction, extensive ophthalmological examination, cicloplegic refraction by retinoscopy and funduscopic examination, OCT, and angio-OCT examination.

Results: Fundoscopic examination in a young patient with previous Sars-CoV-2 infection showed marked vascular tortuosity, evident both at the posterior pole and retinal periphery, especially on the arterial vasculature, and cotton wool spots along the retinal vessels, highlightable also at OCT and angio-OCT examination. These alterations persist at a 6-month follow-up.

Conclusions: In COVID-19 infection, even in asymptomatic pediatric patients, vasculitis develops also affecting the retinal vessels, appreciable on fundus examination. A thorough eye examination in all COVID-19 patients with close follow-up is therefore important. This is the first case report on retinal changes in a pediatric patient.

Keywords: COVID-19; Cotton wool spots; eye; fundus; retina; vascular tortuosity; vasculopathy.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Ocular fundus of both eyes at the first post-Covid 19 visit, showing marked vascular tortuosity, equally visible at the posterior pole and retinal periphery, especially on the arterial vasculature, and cotton wool spots along the retinal vessels.
Figure 2.
Figure 2.
(a) OCT of the right and of the left eye (Heidelberg Spectralis OCT). Cotton wool exudates are visible, as superficial hyper-reflective retinal nodules in contact with the superficial retinal layers. Because of their density, they produce a screen effect on posterior layers. (b) Angio-OCT of the right eye and of the left eye (SOCT Copernicus REVO). Tortuous aspect of the superficial retinal plexus (located in the layer of ganglion cells and nerve fibers) and of the deep retinal plexus (at the internal nuclear and external plexiform layers).
Figure 3.
Figure 3.
Ocular fundus of both eyes at the first post-Covid 19 follow-up, unchanged from the previous one.
See this image and copyright information in PMC

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