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Sinha S, Kumar VB, Anand A, Sinha BP. Bilateral acute macular neuroretinopathy associated with COVID-19 infection presenting with central scotoma. Am J Ophthalmol Case Rep 2024; 35:102001. [PMID: 38827998 PMCID: PMC11141142 DOI: 10.1016/j.ajoc.2024.102001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/23/2023] [Accepted: 01/22/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose To report a case of bilateral acute macular neuroretinopathy (AMN) associated with COVID-19 infection presenting with central scotoma. Observation A 26-year-old female presented with a chief complaint of bilateral central scotomas for the last seven days. She had a history of fever over the past ten days, and RT-PCR test for COVID-19 was positive on the second day of fever. She had been vaccinated against COVID-19 eight months prior. Her best corrected visual acuity was 6/6 in both eyes on the Snellen chart. Dilated fundus evaluation revealed subtle bilateral perifoveal grey macular lesions. Optical coherence tomography (OCT) demonstrated focal hyperreflectivity at the level of the outer nuclear and plexiform layer consistent with bilateral AMN. Near-infrared reflectance (NIR) and red-free (RF) imaging showed large, confluent hyporeflective lesions in the right eye and discrete petaloid lesions with apices pointing toward the fovea in the left eye. OCT angiography (OCTA) revealed decreased flow signal at the level of the deep capillary plexus (DCP) and choriocapillaris (CC) in both eyes. Automated visual field testing (Humprey Field Analyzer (HFA) 24-2) revealed bilateral central scotoma with depression of adjacent points. After two weeks, the patient had depressed visual fields on HFA 10-2. At two months of final follow-up, OCT macula, NIR and RF images revealed resolving AMN lesions in both eyes. OCTA showed an increase in perfusion at the level of the DCP. There was a decrease in scotoma density on HFA 10-2, suggestive of resolving AMN. Conclusion and importance AMN with central scotoma as presenting feature of COVID-19 is rare. Fundus findings may be very subtle in AMN, but NIR and RF imaging delineate the lesions well. OCT, NIR imaging, OCTA and HFA 10-2 can be used to assess the clinical course of AMN.
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Affiliation(s)
- Shivani Sinha
- Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Vidya Bhusan Kumar
- Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Abhishek Anand
- Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Bibhuti Prassan Sinha
- Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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2
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Stawowski AR, Konopińska J, Stawowski SS, Adamczuk J, Groth M, Moniuszko-Malinowska A, Czupryna P. The Review of Ophthalmic Symptoms in COVID-19. Clin Ophthalmol 2024; 18:1417-1432. [PMID: 38803556 PMCID: PMC11129748 DOI: 10.2147/opth.s460224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
The COVID-19 pandemic caused by SARS-CoV-2 had a significant impact on the health of the global human population, affecting almost every human organ, including the organ of vision. Research focus on understanding the pathophysiology, identifying symptoms and complications of the disease. Eye-related pathologies are important foci of research due to the potential for direct impact of the virus. Ophthalmologists around the world are reporting various symptoms of eye infections and ocular pathologies associated with SARS-CoV-2. The review of ophthalmic symptoms was conducted to help physicians of various specialties recognize possible ophthalmic manifestations of this viral disease. A literature review was conducted from January 2020 to July 2023 in the PubMed, MEDLINE, Science Direct, Scopus, Scielo and Google Scholar databases. The review of the literature showed that conjunctivitis is the most common ophthalmic symptom observed during the course of COVID-19 and can occur at any stage of the disease. Changes in the eye may result from the direct effect of the virus, immune response, prothrombotic states, comorbidities, and medications used. Symptoms related to the organ of vision can be divided into: changes affecting the protective apparatus of the eye, the anterior eye segment, the posterior eye segment, neuro-ophthalmic, and orbital changes. Ocular symptoms may suggest COVID-19 infection or appear several weeks after recovery. Following COVID-19 vaccinations, a diverse range of ophthalmic symptoms was observed in various locations and at different times, mirroring the ocular symptoms experienced throughout the course of the COVID-19 illness. It is important for physicians of all specialties to be aware of possible potential connections between eye diseases and SARS-CoV-2, in order to effectively diagnose and treat patients.
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Affiliation(s)
| | - Joanna Konopińska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland
| | | | - Justyna Adamczuk
- Department of Infectious Diseases and Neuroinfectious, Medical University of Bialystok, Bialystok, Poland
| | - Monika Groth
- Department of Allergology and Internal Diseases, University Clinical Hospital in Bialystok, Bialystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfectious, Medical University of Bialystok, Bialystok, Poland
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfectious, Medical University of Bialystok, Bialystok, Poland
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Zaheer N, Tallouzi MO, Kumar NA, Sreekantam S. Outer Retinopathies Associated with COVID-19 Infection: Case Reports and Review of Literature. Case Rep Ophthalmol Med 2024; 2024:7227086. [PMID: 38495090 PMCID: PMC10942824 DOI: 10.1155/2024/7227086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/26/2023] [Accepted: 01/02/2024] [Indexed: 03/19/2024] Open
Abstract
Background The coronavirus disease (COVID-19) is a highly contagious disease with profound health implications. It can affect any part of the body with variable severity. Various ophthalmic manifestations of coronavirus disease have been documented. Case Presentations. We reported three cases of outer retinopathies associated with COVID-19 infection. All three patients were young females. The first two patients presented within days of COVID-19 infection with complaints of black spots in the eyes. Multimodal retinal imaging showed lesions consistent with acute macular neuroretinopathy. Lesions were bilateral in the first patient and unilateral in the second one. Our third patient presented with blurred vision in one eye, 3 months after a suspected COVID-19 infection. Retinal imaging showed outer retinopathy. Our patients' vision was good and maintained during the follow-up. All three were monitored on observation only, and symptoms and lesions improved with time. Conclusion In conclusion, COVID-19-related thromboinflammatory response can result in localized vascular inflammation and hypoperfusion in any of the retinal capillary plexuses or choriocapillaris resulting in ischemia of the corresponding retinal or choroidal layers.
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Affiliation(s)
- Naima Zaheer
- Birmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, Birmingham, UK
| | - Mohammad O. Tallouzi
- Birmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, Birmingham, UK
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - N. Ajith Kumar
- Birmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, Birmingham, UK
| | - Sreekanth Sreekantam
- Birmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, Birmingham, UK
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4
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Wang X, Wang P, Lu J, Ju H, Xie H, Peng H. Acute macular neuroretinopathy and COVID-19 or SARS-CoV-2 infection: case report and literature review. Front Med (Lausanne) 2024; 11:1267392. [PMID: 38384420 PMCID: PMC10879554 DOI: 10.3389/fmed.2024.1267392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
Purpose To describe a case of acute macular neuroretinopathy (AMN) associated with COVID-19 infection and a related literature review. Methods A case from the First Affiliated Hospital of Chongqing Medical University was reported that could be linked to COVID-19 or SARS-CoV-2 infection. We performed a comprehensive search on PubMed, retrieving articles containing information on AMN after COVID-19 or SARS-CoV-2 infection. The key words used were 'COVID-19', 'SARS-CoV-2', 'ophthalmic manifestations', 'acute macular neuroretinopathy', and 'paracentral scotomas'. The relevant data were extracted, charted, consolidated, and evaluated. Moreover, manual exploration of the reference lists of pertinent articles was carried out. Results We describe the case of a 30-year-old young woman who developed bilateral AMN one day after being infected with COVID-19 or SARS-CoV-2. She had severe visual impairment (20/2000 OD and 20/32 OS), and her vision recovered after taking oral corticosteroids. After reviewing the literature, we summarized 16 relevant reports and found that symptoms of AMN tend to arise 1 day to 1 month after COVID-19 or SARS-CoV-2 infection. Contraceptive pills and other risk factors should be avoided to reduce the risk of adverse outcomes. Oral prednisone may be an effective treatment for those experiencing important vision loss. Conclusion Symptoms of AMN can arise 1 day to 1 month after COVID-19 or SARS-CoV-2 infection. Ophthalmologists should remain vigilant about this disease, notably because patient characteristics may deviate from the norm.
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Affiliation(s)
- Xing Wang
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Ophthalmology, Department of Ophthalmology, Chongqing Eye Institute, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Wang
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Ophthalmology, Department of Ophthalmology, Chongqing Eye Institute, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Lu
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Huan Ju
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Hao Xie
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Hui Peng
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Ophthalmology, Department of Ophthalmology, Chongqing Eye Institute, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Mitamura M, Kase S, Hirooka K, Endo H, Ito Y, Ishida S. Choroidal Circulatory and Vascular Morphological Changes in Acute Macular Neuroretinopathy After Infection With Severe Acute Respiratory Syndrome Coronavirus 2: A Case Report With Literature Review. In Vivo 2023; 37:2869-2876. [PMID: 37905626 PMCID: PMC10621410 DOI: 10.21873/invivo.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM The aim of this study was to analyze choroidal circulatory and structural changes using laser speckle flowgraphy (LSFG) and optical coherence tomography (OCT) in acute macular neuroretinopathy (AMN) after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respectively. CASE REPORT A 24-year-old woman complained of distorted vision after SARS-CoV-2 infection oculi uterque (OU) and referred to our hospital because of ellipsoid zones (EZ) disruption on OCT. Her best-corrected visual acuity (BCVA) was 1.2 OU. Color fundus photographs revealed dark red lesions in the macula, and scanning laser ophthalmoscopy infrared images showed hypointensity consistent with dark red lesions OU. We diagnosed the patient with AMN after SARS-CoV-2 infection, and posterior sub-Tenon injections of triamcinolone acetonide were performed OU. Five months after the initial visit, her BCVA was 1.2 OU, and EZ disruption improved. The rate of change in macular blood flow assessed by the mean blur rate on LSFG was 20.4% and 29.6% increase oculus dexter (OD) and oculus sinister (OS) 5 months after the initial visit, respectively. The central choroidal thickness showed 13.5% increase OD and 16.1% increase OS. The binarization technique demonstrated that the ratio of luminal areas in choroidal area increased by 12.6% OD and 14.2% OS, and stromal areas increased by 7.3% OD and 16.9% OS. CONCLUSION Before and after treatment for AMN, the luminal component may have increased with improvement of acute choroidal circulatory disturbance caused by SARS-CoV-2, and increased stromal components may be due to chronic inflammation and tissue remodeling of the stroma.
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Affiliation(s)
- Mizuho Mitamura
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoru Kase
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan;
| | - Kiriko Hirooka
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroaki Endo
- Department of Ophthalmology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yuki Ito
- Department of Ophthalmology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Susumu Ishida
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Interlandi E, Pellegrini F, Giuffrè C, Cirone D, Brocca D, Lee AG, Casalino G. Acute-Onset Retinal Conditions Mimicking Acute Optic Neuritis: Overview and Differential Diagnosis. J Clin Med 2023; 12:5720. [PMID: 37685787 PMCID: PMC10488521 DOI: 10.3390/jcm12175720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/20/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Acute optic neuritis (AON) is a common cause of sudden visual loss in young patients. Because of the risk of demyelinating disease, patients affected by unilateral or bilateral optic neuritis should be evaluated and treated accordingly. Despite advancements in imaging of the brain and retina, misdiagnosis of AON is not uncommon. Indeed, some acute disorders of the retina have the potential to mimic AON and their prompt diagnosis may avoid unnecessary neurologic investigation, psychological stress to the patient, and delays in treatment. This review describes uncommon retinal disorders presenting with sudden-onset visual loss and absent or subtle funduscopic manifestation that can mimic AON. Multimodal retinal imaging is essential in detecting these conditions and in their differential diagnosis. It behooves neurologists and general ophthalmologists to be aware of these entities and be familiar with multimodal imaging of the retina.
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Affiliation(s)
- Emanuela Interlandi
- Department of Ophthalmology, “Ospedale del Mare”, ASL Napoli 1-Centro, 80147 Naples, Italy
| | | | - Chiara Giuffrè
- Centro Europeo di Oftalmologia, 90141 Palermo, Italy;
- Ophthalmology Department, San Raffaele Scientific Institute, University Vita-Salute, 20132 Milan, Italy
| | - Daniele Cirone
- Department of Ophthalmology, “Villa Anna” Hospital, 63074 San Benedetto del Tronto, Italy;
| | - Daniele Brocca
- Department of Ophthalmology, “De Gironcoli” Hospital, AULSS2 Marca Trevigiana, 31015 Conegliano, Italy;
| | - Andrew G. Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX 77030, USA;
- Departments of Ophthalmology, Neurology and Neurosurgery, Weill Cornell Medicine, New York, NY 10021, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX 77555, USA
- University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Texas A and M College of Medicine, Bryan, TX 77807, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| | - Giuseppe Casalino
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
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In the Eye of the Cytokine Storm: A Tale of SARS-CoV-2-Induced Acute Macular Neuroretinopathy. Cureus 2023; 15:e36797. [PMID: 36998919 PMCID: PMC10044158 DOI: 10.7759/cureus.36797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 03/30/2023] Open
Abstract
Acute macular neuroretinopathy (AMN) commonly affects young to middle-aged females and is considered a relatively rare retinal disease, and the etiology is complex. Advances in multimodal imaging provide a better characterization of retinal disorders and have helped identify that one of the etiologies of AMN is microvascular in nature. This case is clinically relevant as it adds to the literature that the pathophysiology of AMN is vascular-driven. Our case is a 24-year-old Black female with no past medical history, the only medication she was taking was an oral contraceptive pill, who presented to the emergency room with a 24-hour history of left central field vision loss and endorsed a recent upper respiratory tract infection preceding the acute vision loss. It was subsequently found on admission that the patient tested positive for and had a SARS-CoV-2 infection. A retina specialist performed optical coherence tomography (OCT), which showed disruption in the outer segment junction, including the ellipsoid zone and outer plexiform. The use of multimodal imaging like OCT helped confirm AMN; therefore, prompt examination by ophthalmology is critical to confirm a correct diagnosis. This patient’s vision improved and remained stable five months later. This case demonstrates that, like other viruses, SARS-CoV-2 has the potential to cause retinal disease complications such as AMN. These findings reinforce and add to the current literature that SARS-CoV-2 can cause multiple-organ system dysfunction at a vascular level through immune-mediated pathways.
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Kurysheva NI, Evdokimova OA, Nikitina AD. Eye damage in COVID-19. Part 2: posterior segment complications, neuro-ophthalmic manifestations, vaccination and risk factors. RUSSIAN OPHTHALMOLOGICAL JOURNAL 2023. [DOI: 10.21516/2072-0076-2023-16-1-157-167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
Posterior eye segment involvement in COVID-19 has varied manifestations: vascular, inflammatory, and neuronal. All of them are triggered by SARS-CoV-2 virus but they cannot be viewed as exclusively specific to COVID-19. According to the literature, the mean age of the patients varies from 17 to 75 with the median of 50 years. The median duration between the appearance of ophthalmic symptoms and the detection of COVID-19 was 12 days. The disease affects both men and women equally. Direct exposure to the virus, immune-mediated tissue damage, activation of the coagulation system, the prothrombotic state caused by a viral infection, concomitant diseases and medications used in the treatment contribute to the development of eye pathologies. Ophthalmologists should be aware of the possible relations of posterior eye segment pathologies, orbit and neuro-ophthalmic disorders with SARS-CoV-2, as well as the possible exacerbation of chronic forms of inflammatory eye diseases and autoimmune disorders due to anti-COVID-19 vaccination.
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Affiliation(s)
- N. I. Kurysheva
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center;
Ophthalmological Center, Federal Medical and Biological Agency
| | - O. A. Evdokimova
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center; Ophthalmological Center, Federal Medical and Biological Agency
| | - A. D. Nikitina
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center; Ophthalmological Center, Federal Medical and Biological Agency
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9
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Dutta Majumder P, Agarwal A. Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy during SARS-CoV-2 Infection and Vaccination. Vaccines (Basel) 2023; 11:vaccines11020474. [PMID: 36851351 PMCID: PMC9962518 DOI: 10.3390/vaccines11020474] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 02/22/2023] Open
Abstract
Purpose: To review the demographic and clinical profile of patients developing acute macular neuroretinopathy (AMN) or paracentral acute middle maculopathy (PAMM) after receiving coronavirus disease-2019 (COVID-19) vaccination or infection. Methods: In this review article, the published literature was searched to determine cases developing either AMN or PAMM after COVID-19 vaccinations or infections. Data, including demographic profile, presenting features, symptoms, diagnosis, and clinical outcomes, were extracted from the selected publications. These parameters were compared between the two groups, i.e., patients developing AMN/PAMM either after vaccination or infection. Results: After the literature review, 57 patients developing either AMN (n = 40), PAMM (n = 14), or both (n = 3) after COVID-19 infection (n = 29) or vaccination (n = 28) were included (mean age: 34.9 ± 14.4 years; n = 38; 66.7% females). In 24.6% patients, the diagnosis of COVID-19 infection was preceded by the development of ocular disease. There were no significant differences in the age or gender between the patients developing AMN or PAMM after vaccination or infection (p > 0.13). Among the vaccination group, the highest number of patients developing AMN/PAMM were after the Oxford-AstraZeneca (n = 12; 42.9%). Patients with vaccination had a significantly early onset of AMN/PAMM compared to those with infection (11.5 ± 17.6 days versus 37.8 ± 43.6 days; p = 0.001). Conclusions: Both AMN and PAMM are reported to be associated with COVID-19 infections and in persons receiving vaccination against COVID-19. While COVID-19 infections and vaccinations may have a contributory role, other risk factors such as oral contraceptive pills may also play a role in the development of the disease.
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Affiliation(s)
- Parthopratim Dutta Majumder
- Medical Research Foundation, Sankara Nethralaya, 18, College Road, Chennai 600006, India
- Correspondence: ; Tel.: +91-44-2827-1616
| | - Aniruddha Agarwal
- Eye Institute, Cleveland Clinic Abu Dhabi (CCAD), Abu Dhabi P.O. Box 112412, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA
- Department of Ophthalmology, Maastricht University Medical Center, 6211 LK Maastricht, The Netherlands
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Fekri S, Khorshidifar M, Dehghani M, Nouri H, Abtahi SH. Acute macular neuroretinopathy and COVID-19 vaccination: Case report and literature review. J Fr Ophtalmol 2023; 46:72-82. [PMID: 36496293 PMCID: PMC9684098 DOI: 10.1016/j.jfo.2022.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review cases of acute macular neuroretinopathy (AMN) after COVID-19 vaccination and add a similar case to the literature. METHODS A thorough PubMed search was conducted, and data from studies describing AMN after COVID-19 vaccination were extracted, tabulated, pooled, and reviewed. RESULTS We present a case of AMN in a young woman 5 days after immunization with the BBIBP-CorV (Sinopharm) COVID-19 vaccine. Data from 21 cases were pooled and reviewed. The most frequent vaccines among the cases were recombinant ones (13/21), followed by mRNA-based (6/21) and inactivated vaccines (2/21). Only one patient (5%) was male. Seventeen over twenty-one (81%) were young women, ages 18-33. Most cases (14/21; 67%) reported recent/concurrent use of contraceptive medication. In 90% of cases (19/21), symptoms appeared within 8 days of vaccination. A confined wedge-/oval-shaped lesion morphology was more frequent than a diffuse, semilunar one. Resolution of symptoms took 4 to over 15 weeks. CONCLUSION Attention should be paid to the history of vaccination and contraceptive use in patients with sudden-onset visual symptoms. Optical coherence tomography is integral to the detection of AMN-related abnormalities.
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Affiliation(s)
- S. Fekri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M. Khorshidifar
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M.S. Dehghani
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - H. Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran,School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Isfahan, Iran,Corresponding author
| | - S.-H. Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Department of Ophthalmology, Torfe Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Clinical Research Development Unit of Torfe Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Cuadros Sánchez C, Egüen CS, Gutierrez-Ezquerro R, Giralt-Peret L, Fonollosa A. Central Retinal Vein Occlusion Presumably Associated with Lupus Anticoagulant Induced by SARSCoV-2. Ocul Immunol Inflamm 2022; 30:2010-2013. [PMID: 34236274 DOI: 10.1080/09273948.2021.1933077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To report a case of unilateral central retinal vein occlusion (CRVO) and macular edema presumably associated with lupus anticoagulant (LA) induced by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). METHOD Case report. RESULTS A 32-year-old male patient presented to the emergency department with a 5-day history of blurry vision. He was diagnosed with a CRVO and macular edema. The only pathological finding was positive LA which could have been induced by his recent confirmed SARS CoV-2 infection. The patient's evolution was satisfactory after two injections of Intravitreal dexamethasone (Ozurdex®), with improvement in macular edema and visual acuity. CONCLUSION COVID-19 may be associated to retinal vascular occlusive disorders. Transient virus-induced LA might play a role in the pathogenesis of the thrombotic event.
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Affiliation(s)
- Carlos Cuadros Sánchez
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
| | - Cristina Sacristán Egüen
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
| | | | - Lena Giralt-Peret
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
| | - Alex Fonollosa
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain.,Department of Ophthalmology, Instituto Oftalmológico Bilbao, Spain
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12
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Naimi A, Yashmi I, Jebeleh R, Imani Mofrad M, Azimian Abhar S, Jannesar Y, Heidary M, Pakzad R. Comorbidities and mortality rate in COVID-19 patients with hematological malignancies: A systematic review and meta-analysis. J Clin Lab Anal 2022; 36:e24387. [PMID: 35385130 PMCID: PMC9102765 DOI: 10.1002/jcla.24387] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The global pandemic of coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It seems that there is an association between blood cancer and an increased risk of severe COVID-19. This study aimed to review the literature reporting the COVID-19 outcomes in patients with hematological malignancies. MATERIAL AND METHODS In this systematic review and meta-analysis, Pubmed, Embase, and Web of Science databases were searched using the following keywords: COVID-19, SARS-CoV-2, blood cancer, myeloma, lymphoma, and leukemia. All the published articles in English from January 1, 2019, until March 10, 2021 were collected and evaluated. RESULTS In total, 53 studies with 2395 patients were included based on inclusion criteria. Most of these studies took place in Spain (14.81%), followed by the USA (11.11%), China (9.26%), and the UK (9.26%). More than half of COVID-19 patients with hematological malignancy were male (56.73%). Oxygen therapy played an important role in COVID-19 treatment. Moreover, anticoagulant therapies such as enoxaparin and heparin were two great assists for these patients. Fever (74.24%), cough (67.64%), and fatigue (53.19%) were the most reported clinical manifestations. In addition, hypertension and dyslipidemia were the most common comorbidities. The mortality rate due to COVID-19 in patients with hematological malignancies was 21.34%. CONCLUSION This study demonstrated that hematologic cancer patients were more susceptible to a severe COVID-19 than patients without blood cancer. Thus, the management of COVID-19 in these patients requires much more attention, and their screening should perform regularly.
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Affiliation(s)
- Adel Naimi
- Cellular and Molecular Research CenterSabzevar University of Medical SciencesSabzevarIran
| | - Ilya Yashmi
- Student Research CommitteeSabzevar University of Medical SciencesSabzevarIran
| | - Reza Jebeleh
- Student Research CommitteeSabzevar University of Medical SciencesSabzevarIran
| | | | | | - Yasaman Jannesar
- Student Research CommitteeSabzevar University of Medical SciencesSabzevarIran
| | - Mohsen Heidary
- Cellular and Molecular Research CenterSabzevar University of Medical SciencesSabzevarIran
- Department of Laboratory SciencesSchool of Paramedical SciencesSabzevar University of Medical SciencesSabzevarIran
| | - Reza Pakzad
- Department of EpidemiologyFaculty of HealthIlam University of Medical SciencesIlamIran
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13
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Sanjay S, Gadde SGK, Kumar Yadav N, Kawali A, Gupta A, Shetty R, Mahendradas P. "Bilateral Sequential Acute Macular Neuroretinopathy in an Asian Indian Female with β Thalassemia Trait following (Corona Virus Disease) COVID-19 Vaccination and Probable Recent COVID Infection- Multimodal Imaging Study.". Ocul Immunol Inflamm 2022; 30:1222-1227. [PMID: 35050826 DOI: 10.1080/09273948.2022.2026978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Corona virus disease (COVID-19) has been associated with a variety of ophthalmic manifestations including acute macular neuroretinopathy and paracentral middle maculopathy. Posterior segment manifestations after post COVID-19 vaccinations have been reported. CASE REPORT A 25- year-old Asian Indian female developed sequential bilateral AMN following a single dose of COVISHIELD™ vaccine. On investigations she was found to have a β thalassemia trait. Presentation started unilaterally and progressed to the other eye after a month. On clinical examination, the fundus was apparently normal in both eyes. Significant changes suggestive of AMN were seen on multimodal imaging of the posterior segment of the respective eye at the time of involvement which resolved spontaneously in due course. CONCLUSION We report a temporal association of COVID-19 vaccination and AMN.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | | | | | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Aditi Gupta
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Neuro-ophthalmology, Narayana Nethralaya, Bangalore, India
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14
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Sanjay S, Agrawal S, Jayadev C, Kawali A, Gowda PB, Shetty R, Mahendradas P. Posterior segment manifestations and imaging features post-COVID-19. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2021; 10:95-106. [PMID: 37641707 PMCID: PMC10460223 DOI: 10.51329/mehdiophthal1427] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/19/2021] [Indexed: 08/31/2023]
Abstract
Background To report the posterior segment (uvea and retinal) manifestations and imaging characteristics of eyes of patients with and after coronavirus disease 2019 (COVID-19). Methods We searched the PubMed/MEDLINE database to identify relevant articles using the following search terms: COVID-19, SARS-CoV-2, retina, uvea, optic nerve, retinal findings, posterior segment manifestations, and endophthalmitis. Articles published from December 1, 2019, to May 30, 2021, and indexed in PubMed/ MEDLINE were screened. Results For the purpose of this review, we included clinical features of 26 case reports and 8 case series. The posterior segment manifestations reported included cotton wool spots, retinal hemorrhages, central serous retinopathy, papillophlebitis, optic neuritis, panuveitis, multifocal retinitis, necrotizing retinitis, central retinal artery/vein occlusion, and Purtschner like retinopathy. In this review, we have also included optical coherence tomography angiography (OCTA) features that have been described in COVID-19 patients with pneumonia. Conclusions COVID-19 patients can experience uveo-retinal manifestations even after recovery. These patients, even if asymptomatic for eye symptoms, should undergo an eye evaluation to rule out posterior segment involvement. OCTA performed in these patients revealed microvascular changes in the superficial and deep retinal plexuses. Some of these patients may require anticoagulant or antiplatelet therapy.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Sameeksha Agrawal
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
- Department of Retina, Narayana Nethralaya, Bangalore, India
| | | | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | | | - Rohit Shetty
- Department of Neuro-ophthalmology, Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
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15
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David JA, Fivgas GD. Acute macular neuroretinopathy associated with COVID-19 infection. Am J Ophthalmol Case Rep 2021; 24:101232. [PMID: 34778601 PMCID: PMC8577875 DOI: 10.1016/j.ajoc.2021.101232] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/30/2021] [Accepted: 11/08/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose To report a case of bilateral acute macular neuroretinopathy (AMN) associated with a COVID-19 infection. Observations A 22-year-old female was referred for evaluation of bilateral scotomas concurrent with a mildly symptomatic COVID-19 infection. Exam showed normal visual acuity, bilateral reddish-brown petaloid retinal lesions which were hyporeflective on near infrared (NIR) optical coherence tomography (OCT), and had associated hypoperfusion of the deep vascular plexus on OCT-angiography (OCT-A) consistent with bilateral AMN. At follow-up, scotomas and retinal findings on near infrared imaging and spectral-domain optical coherence tomography had only slightly improved. Conclusions COVID-19 has been documented to be the etiology of a growing number of ocular manifestations including microvascular events. We report a case of bilateral acute macular neuroretinopathy in a patient with a recent diagnosis of COVID-19 infection that had persistent symptoms and findings at six month follow-up.
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Affiliation(s)
- James A David
- Louisiana State University Health Sciences Center, Department of Ophthalmology, 533 Bolivar St, Room 451B, New Orleans, LA, 70112, USA
| | - George D Fivgas
- Louisiana State University Health Sciences Center, Department of Ophthalmology, 533 Bolivar St, Room 451B, New Orleans, LA, 70112, USA.,The Retina Center, 7777 Hennessy Blvd, Ste 3000, Baton Rouge, LA, 70808, USA
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16
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Abrishami M, Hassanpour K, Hosseini S, Emamverdian Z, Ansari-Astaneh MR, Zamani G, Gharib B, Abrishami M. Macular vessel density reduction in patients recovered from COVID-19: a longitudinal optical coherence tomography angiography study. Graefes Arch Clin Exp Ophthalmol 2021; 260:771-779. [PMID: 34636996 PMCID: PMC8505785 DOI: 10.1007/s00417-021-05429-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 12/19/2022] Open
Abstract
Background/aims To quantify the longitudinal changes of the macular microvasculature and the foveal avascular zone (FAZ) parameters in patients recovered from coronavirus disease-2019 (COVID-19) using optical coherence tomography angiography (OCTA) analysis. Methods This observational, longitudinal study was performed on patients recovered from COVID-19. The OCTA images were recorded at baseline and after 1 and 3 months at the follow-up examination. Vessel density (VD) of the retinal superficial (SCP) and deep capillary plexus (DCP), as well as the area of the FAZ of patients who had recovered from COVID-19, were measured. Results In total, 36 eyes of 18 patients (62.2% female) with a mean age of 34.5 ± 7.5 years old were included. Regarding SCP, while the VDs of the whole image, fovea, and parafovea were comparable at different time points, the mean VDs in inferior hemifield, as well as superior and inferior regions of perifovea, underwent significant reductions at month 3, compared to the baseline. In DCP, the mean of VD in the whole image was 54.3 ± 2.7 at the first visit which significantly decreased to 52.1 ± 3.8(P = 0.003) and 51.4 ± 2.7(P = 0.001) after 1 and 3 months, respectively. The VDs in all regions of parafovea and perifovea revealed a significant reduction after 1 and 3 months, compared to the first visit. The mean FAZ area was 0.27 ± 0.08 mm2, 0.26 ± 0.08 mm2, and 0.27 ± 0.08 mm2 at the baseline, month 1, and month 3, respectively (P > 0.05). Conclusion Based on the results, the patients who had recovered from COVID-19 had a progressive decrease of VD at the follow-up visit 3 months after COVID-19 infection.
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Affiliation(s)
- Mojtaba Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Eye Research Center, Khatam-al-Anbia Eye Hospital, Qarani Blvd, Mashhad, 9195965919, Iran.
| | - Kiana Hassanpour
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Emamverdian
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ghodsieh Zamani
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bahareh Gharib
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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17
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Macé T, Pipelart V. Acute macular neuroretinopathy and SARS-CoV-2 infection: Case report. J Fr Ophtalmol 2021; 44:e519-e521. [PMID: 34625310 PMCID: PMC8426190 DOI: 10.1016/j.jfo.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 10/25/2022]
Affiliation(s)
- T Macé
- Department of Ophthalmology, Angers University Hospital, 4, rue Larrey, 49933 Angers cedex, France; Department of Ophthalmology, Le Mans Hospital, 194, avenue Rubillard, 72037 Le Mans, France.
| | - V Pipelart
- Department of Ophthalmology, Angers University Hospital, 4, rue Larrey, 49933 Angers cedex, France
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18
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Masjedi M, Pourazizi M, Hosseini N. Acute macular neuroretinopathy as a manifestation of coronavirus disease 2019: A case report. Clin Case Rep 2021; 9:e04976. [PMID: 34703607 PMCID: PMC8521194 DOI: 10.1002/ccr3.4976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/04/2021] [Indexed: 11/17/2022] Open
Abstract
The current findings is important in raising clinicians' awareness of the possibility of coincident acute macular neuroretinopathy (AMN) and COVID-19 as a potential cause of retinal vascular damage and ischemia.
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Affiliation(s)
- Marjan Masjedi
- Isfahan Eye Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Mohsen Pourazizi
- Isfahan Eye Research CenterDepartment of OphthalmologyIsfahan University of Medical SciencesIsfahanIran
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19
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Drüke D, Pleyer U, Hoerauf H, Feltgen N, Bemme S. Acute macular neuroretinopathy (AMN) following COVID-19 vaccination. Am J Ophthalmol Case Rep 2021; 24:101207. [PMID: 34580648 PMCID: PMC8457905 DOI: 10.1016/j.ajoc.2021.101207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/14/2021] [Accepted: 09/20/2021] [Indexed: 11/06/2022] Open
Abstract
Purpose To describe a case of acute macular neuroretinopathy (AMN) in a 23-year-old Caucasian female after a COVID-19 vaccination (Vaxzevira). Observations Our patient perceived visual symptoms in both eyes one day after COVID-19 vaccination. Hyporeflective petalloid shaped perifoveal lesions appeared in infrared reflectance (IR) imaging, and Spectral domain-optical coherence tomography (SD-OCT) revealed structural alterations of outer retinal layers that resulted in persistent disruption of the ellipsoid zone (EZ) and the interdigitation zone (IZ). Conclusions and importance We report a novel association between AMN and COVID-19 vaccination. In addition to a febrile infection and oral contraception, previous vaccination should also be considered a potential risk factor for AMN.
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Affiliation(s)
- Daniela Drüke
- University Medical Center Goettingen, Department of Ophthalmology, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Uwe Pleyer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Ophthalmology, Campus Virchow, Charité, 13353, Berlin, Germany
| | - Hans Hoerauf
- University Medical Center Goettingen, Department of Ophthalmology, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Nicolas Feltgen
- University Medical Center Goettingen, Department of Ophthalmology, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Sebastian Bemme
- University Medical Center Goettingen, Department of Ophthalmology, Robert-Koch-Straße 40, 37075, Göttingen, Germany
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20
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Pachychoroid Spectrum Disorder Findings in Patients with Coronavirus Disease 2019. Case Rep Ophthalmol Med 2021; 2021:4688764. [PMID: 34557319 PMCID: PMC8455221 DOI: 10.1155/2021/4688764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 08/27/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose To report the occurrence of acute, bilateral, central serous chorioretinopathy (CSC), and pachychoroid spectrum disorder findings in patients with coronavirus disease 2019 (COVID-19). Methods In recovered cases of COVID-19 with visual disturbances, complete ocular examinations with multimodal retinal and choroidal evaluation, including enhanced depth imaging optical coherence tomography, fluorescein or indocyanine green angiography, and blue autofluorescence, were obtained. Results Four COVID-19 recovered patients presented with bilateral blurred vision. Ocular examination and imaging revealed pachychoroid and pachyvessels associated with choroidal hyperpermeability without any obvious intraocular inflammation. Bilateral localized serous retinal detachment was obvious in three cases compatible with pachychoroid associated with CSC manifestation and pachychoroid pigment epitheliopathy in one patient. CSC was resolved with treatment by steroidal antimineralocorticoid (Eplerenone) in two patients and by photodynamic therapy in one patient. None of the patients reported emotional stress and history of corticosteroid consumption. Conclusion Hyperpermeability of the choroid, pachychoroidopathy, or choroidal vessel congestion can be observed or exacerbated in association with COVID-19.
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21
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Diafas A, Ghadiri N, Beare N, Madhusudhan S, Pearce I, Tan SZ. Comment on: 'Paracentral acute middle maculopathy and acute macular neuroretinopathy following SARS-CoV-2 infection'. Eye (Lond) 2021; 36:1507-1509. [PMID: 34341483 PMCID: PMC8327597 DOI: 10.1038/s41433-021-01709-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/03/2021] [Accepted: 07/16/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Asterios Diafas
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
| | - Nima Ghadiri
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Nick Beare
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - Savita Madhusudhan
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - Ian Pearce
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - Shi Zhuan Tan
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
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22
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Mambretti M, Huemer J, Torregrossa G, Ullrich M, Findl O, Casalino G. Acute Macular Neuroretinopathy following Coronavirus Disease 2019 Vaccination. Ocul Immunol Inflamm 2021; 29:730-733. [PMID: 34187278 DOI: 10.1080/09273948.2021.1946567] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To report acute macular neuroretinopathy (AMN) in two young women two days after receiving Vaxzevria Coronavirus disease (COVID-19) vaccination.Methods: Observational case reports.Observation: The first patient was an Italian 22-year-old female with acute onset of paracentral scotoma two days post vaccination. The second patient was an Austrian 28-year-old female who presented with sudden onset paracentral scotoma two days after vaccination. Multimodal retinal imaging was consistent with AMN in both cases. Both patients were on long-term oral contraceptives, had no history of COVID-19 and experienced one-day duration fever the day after the vaccination.Conclusions: Vaccination may represent a possible risk factor for AMN onset in women on oral contraceptives. We encourage ophthalmologists to investigate recent vaccination status when dealing with new onset AMN. Further studies are needed to assess the link between vaccinations and AMN.
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Affiliation(s)
| | - Josef Huemer
- Vienna Institute for Research in Ocular Surgery, Vienna, Austria.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Marlies Ullrich
- Vienna Institute for Research in Ocular Surgery, Vienna, Austria
| | - Oliver Findl
- Vienna Institute for Research in Ocular Surgery, Vienna, Austria
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23
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Acute macular neuroretinopathy following COVID-19 vaccination. Eye (Lond) 2021; 36:644-645. [PMID: 34158652 PMCID: PMC8217204 DOI: 10.1038/s41433-021-01610-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 04/29/2021] [Accepted: 05/13/2021] [Indexed: 12/14/2022] Open
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24
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Goyal M, Murthy SI, Annum S. Retinal manifestations in patients following COVID-19 infection: A consecutive case series. Indian J Ophthalmol 2021; 69:1275-1282. [PMID: 33913876 PMCID: PMC8186578 DOI: 10.4103/ijo.ijo_403_21] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose To describe retinal manifestations seen in patients associated with COVID-19 infection at a multi-specialty tertiary care hospital in Southern India. Methods In this retrospective chart review, all consecutive cases presenting to the Retina-Uveitis service from May 2020 to January 2021 with retinal manifestations associated with COVID-19 infection or its sequelae or as a result of treatment given for COVID-19 were included. Results : Of the 7 patients, 3 were female, and 4 were male. Four patients had onset of symptoms during the active phase of COVID-19 infection. Four had bilateral and three had unilateral involvement. The manifestations ranged from mild to vision threatening. Vision threatening manifestations included infections: endogenous endophthalmitis, candida retinitis and tubercular choroidal abscess and bilateral pre-foveal hemorrhages. Milder manifestations included paracentral acute middle maculopathy, central serous chorio-retinopathy and voriconazole induced visual symptoms. Final visual acuity was 6/36 or better in the four severe cases and 6/9 or better in the mild cases. Conclusion This study highlights the retinal manifestations associated with COVID-19 infection and its sequelae. As these patients presented with an association with COVID-19 (either during or after recovery), ophthalmologists should be vigilant and screen for such entities in case of complaints of visual symptoms or in the presence of systemic sepsis. The outcomes can be good with prompt and aggressive management.
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Affiliation(s)
- Mallika Goyal
- Retina-Uveitis Service, Department of Ophthalmology, Apollo Health City, Hyderabad, Telangana, India
| | | | - Sridhar Annum
- Retina-Uveitis Service, Department of Ophthalmology, Apollo Health City, Hyderabad, Telangana, India
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25
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Sen M, Honavar SG, Sharma N, Sachdev MS. COVID-19 and Eye: A Review of Ophthalmic Manifestations of COVID-19. Indian J Ophthalmol 2021; 69:488-509. [PMID: 33595463 PMCID: PMC7942063 DOI: 10.4103/ijo.ijo_297_21] [Citation(s) in RCA: 141] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023] Open
Abstract
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had health implications of unprecedented magnitude. The infection can range from asymptomatic, mild to life threatening respiratory distress. It can affect almost every organ of the body. Ophthalmologists world over are reporting various manifestations of the infection in the eye. This review was undertaken to help ophthalmologists recognize the possible manifestations and the stage of the viral disease when they commonly appear. Literature search was performed for the publications on ophthalmic manifestations of coronavirus disease-19 (COVID-19) between January 1, 2020 and January 31, 2021. 46 case reports, 8 case series, 11 cross sectional/cohort observational studies, 5 prospective interventional studies, 3 animal models/autopsy studies and 6 reviews/meta-analysis were included. Conjunctivitis is the most common manifestation and can develop at any stage of the disease. Direct effect due to virus, immune mediated tissue damage, activation of the coagulation cascade and prothrombotic state induced by the viral infection, the associated comorbidities and drugs used in the management are responsible for the findings in the eye. The viral ribonucleic acid (RNA) has been isolated from ocular tissues but the role of eye as a route for infection is yet to be substantiated. Ophthalmic manifestations may be the presenting feature of COVID-19 infection or they may develop several weeks after recovery. Ophthalmologists should be aware of the possible associations of ocular diseases with SARS-CoV-2 in order to ask relevant history, look for specific signs, advise appropriate tests and thereby mitigate the spread of infection as well as diagnose and initiate early treatment for life and vision threatening complications.
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Affiliation(s)
- Mrittika Sen
- Ophthalmic and Facial Plastic Surgery and Ocular Oncology Services, Centre for Sight, Hyderabad, Telangana, India
| | - Santosh G Honavar
- Ophthalmic and Facial Plastic Surgery and Ocular Oncology Services, Centre for Sight, Hyderabad, Telangana, India
| | - Namrata Sharma
- Cornea and Refractive Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mahipal S Sachdev
- President, All India Ophthalmological Society and Chairman, Centre for Sight, New Delhi, India
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