Monferrer-Adsuara Clara, Castro-Navarro Verónica, González-Girón Nuria, Remolí-Sargues Lidia, Ortiz-Salvador Miguel, Montero-Hernández Javier, Cervera-Taulet Enrique
Hospital General Universitario de Valencia, Valencia, Spain.
Facultad de Medicina, Universidad Católica de Valencia 'San Vicente Mártir', Valencia, Spain.
Eur J Ophthalmol. 2020 Dec 22:1120672120984381. doi: 10.1177/1120672120984381.
There have been anecdotal reports of ocular manifestations in the Coronavirus Disease 2019 (COVID-19). As the pandemic is spreading and the whole picture is yet unknown, ophthalmologists should be aware of unusual ocular presentations of COVID-19 since they could precede the development of severe respiratory distress.
We report here the first case of a patient with bilateral unusual dot-blot retinal hemorrhages and retinal venous dilation who presented shortly thereafter a PCR-proven COVID-19.
A 59-year-old woman presented with a 7 days history of blurred vision in both eyes. Fundus examination revealed bilateral venous stasis and dot and blot intra-retinal hemorrhages preceding the diagnosis of COVID-19 in a patient with mild respiratory symptoms that progressed within a few days to a severe respiratory distress. After 1 month of the COVID-19 treatment, fundus examination improved and fluorescein angiography demonstrated no diabetic retinopathy signs, no retinal vasculitis and no significant delay in arterial or venous filling.
Intraretinal hemorrhages similar to those found in the retinopathy associated to blood dyscrasias could be an association with SARS-CoV-2 in the context of a coagulopathy induced by the infection.
有关于2019冠状病毒病（COVID-19）眼部表现的传闻报道。随着疫情蔓延且整体情况尚不明朗，眼科医生应意识到COVID-19不寻常的眼部表现，因为它们可能先于严重呼吸窘迫的出现。
我们在此报告首例患者，其双眼出现不寻常的点状和斑片状视网膜出血及视网膜静脉扩张，随后不久经PCR证实感染了COVID-19。
一名59岁女性，双眼视力模糊7天。眼底检查发现，该患者在诊断为COVID-19之前，双眼存在静脉淤滞以及视网膜内点状和斑片状出血，其有轻度呼吸道症状，数天内进展为严重呼吸窘迫。COVID-19治疗1个月后，眼底检查有所改善，荧光素血管造影显示无糖尿病视网膜病变迹象、无视网膜血管炎，动脉或静脉充盈无明显延迟。
与血液系统疾病相关视网膜病变中发现的类似视网膜内出血，可能与感染诱导的凝血病背景下的SARS-CoV-2有关。
