Ophthalmic and Neuro-ophthalmic Manifestations of Coronavirus Disease 2019 (COVID-19)

ABSTRACT

Purpose

To describe a case of inflammatory chorioretinopathy and Adie’s syndrome possibly associated with COVID-19.

Methods

Observational case report.

Results

A 51-year-old woman developed fever, cough, and headache followed by retro-ocular pain and reading impairment. She tested positive for SARS-COV-2 infection by qualitative real-time reverse-transcriptase-polymerase-chain-reaction. The slit-lamp and funduscopic exam revealed abnormal pupillary response and yellowish creamy deep chorioretinal lesions, which were not present in previous examinations. Instillation of pilocarpine demonstrated denervation supersensitivity, and it was suggestive of bilateral Adie tonic pupil. A comprehensive work-up ruled out other systemic, autoimmune, or infectious diseases.

Conclusions

This case illustrates the possible association between multifocal chorioretinitis and Adie’s syndrome, and the SARS-COV-2 infection in humans. Further investigation of virus infectivity specifically within ocular tissues has to be conducted.

KEYWORDS:

• COVID-19
• ophthalmic manifestation
• Adie’s pupil
• inflammatory chorioretinopathy
• multimodal imaging

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Ethics Statement

Ethical approval from our institution has been obtained.

Written informed consent was obtained from the patient.

This study adheres to the Declaration of Helsinki.