An analysis of the clinical profile of patients with uveitis following COVID-19 infection

Abstract

Purpose: To describe the clinical profile of patients presenting with uveitis following COVID-19 infection at a tertiary care eye hospital in South India.

Methods: In this retrospective chart review, all consecutive cases presenting with an acute episode of intraocular inflammation and a history of COVID-19 infection diagnosed within the preceding 6 weeks, between March 2020 and September 2021, were included. Data retrieved and analyzed included age, sex, laterality of uveitis, and site of inflammation. The diagnosis was categorized based on the SUN working group classification criteria for uveitis. Details regarding clinical features, investigations, ophthalmic treatment given, response to treatment, ocular complications, and status at last visit were also accessed. Statistical analysis of demographical data was done using Microsoft Excel 2019.

Results: Twenty-one eyes of 13 patients were included in this hospital-based retrospective observational study. The study included six male and seven female patients. The mean age was 38 ± 16.8 years. Eight patients had bilateral involvement. Seven patients were diagnosed with anterior uveitis, three with intermediate uveitis, one with posterior uveitis, and two with panuveitis. All patients responded well to treatment and were doing well at their last visit. Two patients had complications that necessitated surgical treatment, following which they recovered good visual outcomes.

Conclusion: With prompt diagnosis and appropriate management, all the patients with uveitis post-COVID-19 infection recovered with good visual outcomes. Thus, ophthalmologists must be aware of the possible uveitic manifestations following even uneventful COVID-19 infection.

Keywords: Anterior uveitis; COVID-19; intermediate uveitis; neuroretinitis; panuveitis; uveitis.

Figure 1

Patient 7 with BADI. Slit-lamp photograph of the right eye (a) and left eye (b) showing non transilluminating depigmentation of the iris

Figure 2

Patient 11 with bilateral post fever retinitis. (a and d) Fundus photography of right (a) and left (d) eyes - multiple retinitis patches at the macula and peripapillary region, macular exudates. (b and e) Late phase of FFA of right (b) and left (e) eyes showing hypofluorescent areas with hyperfluorescent edges corresponding to the retinitis patches and disc leakage. OCT of right (b) eye showing resolved macular edema and left eye (e) showing subretinal and intraretinal fluid. (c and f) Fundus photography of right (c) and left (f) eyes at the last visit showing considerable inflammation resolution

Figure 3

Patient 13 with bilateral panuveitis. (a and d) Slit-lamp photograph of right (a) and left (d) eyes showing posterior synechiae. (b and e) Color fundus photography at presentation of right (b) eye showing the severe hazy view with disc barely visible and left (e) eye showing moderate haze. (c and f) Color fundus photography at last visit of right (c) and left (f) eyes showing resolution of inflammation