Central Retinal Vein Occlusion as a complication of COVID-19

Author: Valvita Reci (Macedonia, the former Yugoslav Republic of)

Co-authors: Mohamed Tawfik, Mahmoud Kesba

Purpose

To present an interesting case report of a healthy 34-year old female who presented to our ophthalmology clinic with unilateral non ischemic central retinal vein occlusion, two months after she was tested positive for SARS-CoV-2.

Setting/Venue

University Clinic for Eye Diseases, Skopje, North Macedonia

Methods

We present a 34-y old female who was referred to our ophthalmology clinic with blurred vision in her right eye, without other systemic symptoms. She was diagnosed as COVID-19 two months before onset of her visual symptoms. Further investigation ruled out any medical disease or any other known etiological factor related to hypercoagulable state. Complete blood analysis were done, including risk factors for hypercoagulability and were found to be within normal limits, except the high erythrocite sedimentation rate.

Results

During eye examination BCVA was 6/6 on both eyes. On slit-lamp examination, the anterior segment was within normal limits, including intraocular pressure. On fundus examination, the right eye showed tortuosity and dilatation of all branches of the central retinal vein, dot-blot and flame-shaped hemorrhages in all four quadrants. Fluorescein angiography showed marked delay in arteriovenous transit time, staining of dilated tortuous veins and masking by retinal hemorrhages, confirming non ischemic central retinal vein occlusion. OCT imaging did not show macular edema and therefore she was not treated. The patient was followed-up monthly till complete resolution of symptoms and gradually improvement of the retinal vascular appearance.

Conlusions

The hypercoagulable state induced by COVID-19 may be linked with CRVO, which itself is associated with the presence of hypercoagulation. This may implicate awaring of COVID-19 related thromboembolic phenomena as a cause of CRVO. We hope that our case report that illustrate CRVO as a compication of COVID-19 will allow us to increase more our knowledge about various possible ocular manifestations of COVID-19 disease. Further studies and case reports should be reported to better understand the connectivity between Covid-19 and retinal vascular diseases.

Financial Disclosure

No financial interest or relations