Bilateral Post Fever Retinitis With Retinal Vascular Occlusions Following Severe Acute Respiratory Syndrome Corona Virus (SARS-CoV2) Infection

ABSTRACT

Introduction

As the world fights the pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several reports of retinal manifestations of the disease are emerging. Post fever retinitis is a well reported ocular inflammatory reaction to multiple invasive agents, be it virus, bacteria or other microbial agent.

Purpose

We report an interesting case of bilateral multifocal retinitis with multiple vascular occlusions in a patient, three weeks after a febrile illness.

Results

Investigations to ascertain the cause of fever resulted in identifying ephemeral seropositivity for several different Ribonucleic acid (RNA) viruses. The retinitis was managed with systemic steroids, doxycycline and anticoagulants with improvement in vision.

Conclusion

High and persistent seropositive response against (SARS-CoV-2) helped us to narrow it as the causative agent but the cross reactivity of SARS-CoV-2 with other viruses can be misleading and needs careful interpretation.

KEYWORDS:

• Multifocal retinitis
• SARS-CoV-2
• COVID-19
• vascular occlusions
• RT- PCR
• Ig M
• IgG SARS-CoV-2

Acknowledgments

Dr. Venkata Ramana Anandula, Chief Microbiologist from Narayana Nethralaya, Bangalore India for helping us with RT PCR testing.

Dr. K.C.Nischal, Dermatologist for his opinion.

Dr. Narsing A Rao, Interim Dean, Keck School of Medicine of USC, Grace and Emery Beardsley Professor in Ophthalmology, USA for his guidance.

Dr. K. Bhujang K Shetty, Chairman Narayana Nethralaya, Bangalore, India for his support.

Declaration of interest

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