TY - JOUR
T1 - Hemi- and Central Retinal Vein Occlusion Associated with COVID-19 Infection in Young Patients without Known Risk Factors
AU - Ashkenazy, Noy
AU - Patel, Nimesh A.
AU - Sridhar, Jayanth
AU - Yannuzzi, Nicolas A.
AU - Belin, Peter J.
AU - Kaplan, Richard
AU - Kothari, Nikisha
AU - Benitez Bajandas, Gabriel A.
AU - Kohly, Radha P.
AU - Roizenblatt, Roberto
AU - Pinhas, Alexander
AU - Mundae, Rusdeep
AU - Rosen, Richard B.
AU - Ryan, Edwin H.
AU - Chiang, Allen
AU - Chang, Louis K.
AU - Khurana, Rahul N.
AU - Finn, Avni P.
N1 - Publisher Copyright:
© 2022 American Academy of Ophthalmology
PY - 2022/6
Y1 - 2022/6
N2 - Purpose: Venous thromboembolic complications have been reported in association with coronavirus disease 2019 (COVID-19) infection. We raised awareness regarding a potential temporal association between COVID-19 infection and retinal vein occlusion (RVO). Design: Multicenter, retrospective, nonconsecutive case series. Subjects: Patients presenting with hemi-RVO (HRVO) or central RVO (CRVO) between March 2020 and March 2021, with confirmed COVID-19 infection, were included. The exclusion criteria were as follows: age >50 years, hypertension, diabetes, glaucoma, obesity, underlying hypercoagulable states, and those requiring intubation during hospitalization. Methods: This was a multicenter, retrospective, nonconsecutive case series including patients presenting with hemi-RVO (HRVO) or central RVO (CRVO) between March 2020 and March 2021, with confirmed COVID-19 infection. The exclusion criteria were as follows: age >50 years, hypertension, diabetes, glaucoma, obesity, underlying hypercoagulable states, and those requiring intubation during hospitalization. Main Outcome Measures: Ophthalmic findings, including presenting and final visual acuity (VA), imaging findings, and clinical course. Results: Twelve eyes of 12 patients with CRVO (9 of 12) or HRVO (3 of 12) after COVID-19 infection were included. The median age was 32 years (range, 18–50 years). Three patients were hospitalized, but none were intubated. The median time from COVID-19 diagnosis to ophthalmic symptoms was 6.9 weeks. The presenting VA ranged from 20/20 to counting fingers, with over half (7 of 12) having a VA of ≥20/40. OCT revealed macular edema in 42% of the eyes; of these, 80% (4 of 5) were treated with anti-VEGF injections. Ninety-two percent (11 of 12) had partial or complete resolution of ocular findings at final follow-up. Four eyes (33%) had retinal thinning, as determined using OCT, by the end of the study interval. The final VA ranged from 20/20 to 20/60, with 11 of the 12 (92%) eyes achieving a VA of ≥20/40 at a median final follow-up period of 13 weeks (range, 4–52 weeks). Conclusions: Although we acknowledge the high seroprevalence of COVID-19 and that a causal relationship cannot be established, we reported this series to raise awareness regarding the potential risk of retinal vascular events due to a heightened thromboinflammatory state associated with COVID-19 infection.
AB - Purpose: Venous thromboembolic complications have been reported in association with coronavirus disease 2019 (COVID-19) infection. We raised awareness regarding a potential temporal association between COVID-19 infection and retinal vein occlusion (RVO). Design: Multicenter, retrospective, nonconsecutive case series. Subjects: Patients presenting with hemi-RVO (HRVO) or central RVO (CRVO) between March 2020 and March 2021, with confirmed COVID-19 infection, were included. The exclusion criteria were as follows: age >50 years, hypertension, diabetes, glaucoma, obesity, underlying hypercoagulable states, and those requiring intubation during hospitalization. Methods: This was a multicenter, retrospective, nonconsecutive case series including patients presenting with hemi-RVO (HRVO) or central RVO (CRVO) between March 2020 and March 2021, with confirmed COVID-19 infection. The exclusion criteria were as follows: age >50 years, hypertension, diabetes, glaucoma, obesity, underlying hypercoagulable states, and those requiring intubation during hospitalization. Main Outcome Measures: Ophthalmic findings, including presenting and final visual acuity (VA), imaging findings, and clinical course. Results: Twelve eyes of 12 patients with CRVO (9 of 12) or HRVO (3 of 12) after COVID-19 infection were included. The median age was 32 years (range, 18–50 years). Three patients were hospitalized, but none were intubated. The median time from COVID-19 diagnosis to ophthalmic symptoms was 6.9 weeks. The presenting VA ranged from 20/20 to counting fingers, with over half (7 of 12) having a VA of ≥20/40. OCT revealed macular edema in 42% of the eyes; of these, 80% (4 of 5) were treated with anti-VEGF injections. Ninety-two percent (11 of 12) had partial or complete resolution of ocular findings at final follow-up. Four eyes (33%) had retinal thinning, as determined using OCT, by the end of the study interval. The final VA ranged from 20/20 to 20/60, with 11 of the 12 (92%) eyes achieving a VA of ≥20/40 at a median final follow-up period of 13 weeks (range, 4–52 weeks). Conclusions: Although we acknowledge the high seroprevalence of COVID-19 and that a causal relationship cannot be established, we reported this series to raise awareness regarding the potential risk of retinal vascular events due to a heightened thromboinflammatory state associated with COVID-19 infection.
KW - COVID-19
KW - Macular edema
KW - Retinal vascular disease
KW - Retinal vein occlusion
KW - Venous thromboembolism
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U2 - 10.1016/j.oret.2022.02.004
DO - 10.1016/j.oret.2022.02.004
M3 - Article
C2 - 35278727
AN - SCOPUS:85127851894
SN - 2468-7219
VL - 6
SP - 520
EP - 530
JO - Ophthalmology Retina
JF - Ophthalmology Retina
IS - 6
ER -