Simultaneous Bilateral Central Retinal Artery Occlusion following COVID-19 Infection

ABSTRACT

Purpose: Coronavirus-19 disease (COVID-19) has been associated with a high risk of thrombotic complications. Here, we report the case of a patient who developed simultaneous bilateral retinal artery occlusion following COVID-19 infection.

Case Report: A 42-year-old male with no systemic co-morbidities presented with sudden, painless loss of vision in both eyes. Fundoscopy showed retinal edema and cherry-red spots in both eyes. Fluorescein angiography showed reperfusion, absence of choroidal ischemia, and Optical Coherence Tomography showed thickened inner retinal layers suggestive of retinal edema and the outer retinal layers appeared intact. Blood investigations for vasculitis, coagulation profile, lipids, and homocysteine level were within normal limits.

Conclusion: COVID-19 patients may develop a systemic coagulopathy and acquired thrombophilia characterized by a tendency for venous, arterial, and microvascular thrombosis. This hypercoagulable state is believed to be a hyperinflammatory response; physicians and ophthalmologists, alike, should be aware of these possible long-term sequelae.

KEYWORDS:

• Coronavirus
• CRAO
• retinal vascular occlusion
• CRVO
• embolism
• retinal ischemia

Declaration of interest statement

Akshay Gopinathan Nair is a consultant for HelpMeSee Inc. and has received lecture fees from Carl Zeiss Meditec Inc. None of the authors have any conflicts of interest to report. The authors alone are responsible for the content and writing of the paper.