de Souza Eduardo Cunha, de Campos Vania Ewert, Duker Jay S
Faculdade de Medicina Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil.
Hospital de Olhos Paulista (HOlhos), Sao Paulo, Brazil.
Am J Ophthalmol Case Rep. 2021 Jun;22:101034. doi: 10.1016/j.ajoc.2021.101034. Epub 2021 Feb 19.
To present a case of an atypical unilateral multifocal choroiditis that occurred in temporal association to an acute covid-19 infection.
A 23-year-old highly myopic man presented with reduced vision in the right eye while under medical quarantine due to direct exposure to COVID-19 infection. Five days after developing mild COVID symptoms (fever, cough and anosmia) he noticed acute painless loss of central vision in his right eye. Systemic evaluation at presentation was positive for SARS-CoV-2 detected via both a pharyngeal swab and serologic titers. Dilated fundus exam was performed, followed by color fundus pictures, optic coherence tomography (OCT), fundus autofluorescence (FAF) and fluorescein angiography (FA).
Fundoscopic examination of the right eye revealed the presence of multiple discrete, slightly elevated yellow-whitish placoid lesions at the posterior pole. The visual acuity was 20/800. The left eye was normal with 20/20 vision. The patient was placed on oral corticosteroids and the lesions rapidly improved.
The patient had an MFC chorioretinitis around the same time that he had a documented acute covid infection. Though the temporal relationship could be by chance alone, communicating this case to the ophthalmic community is warranted to see if other similar cases are noted.
报告一例非典型单侧多灶性脉络膜炎病例,该病例与急性新冠病毒感染存在时间上的关联。
一名23岁的高度近视男性,因直接接触新冠病毒感染而处于医学隔离期间,出现右眼视力下降。在出现轻微新冠症状(发热、咳嗽和嗅觉丧失)五天后,他注意到右眼出现急性无痛性中心视力丧失。就诊时的全身评估显示,通过咽拭子和血清学检测,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)呈阳性。进行了散瞳眼底检查,随后拍摄了彩色眼底照片、光学相干断层扫描(OCT)、眼底自发荧光(FAF)和荧光素血管造影(FA)。
右眼眼底检查发现后极部有多个离散的、略隆起的黄白色类脂样病变。视力为20/800。左眼正常,视力为20/20。患者接受口服皮质类固醇治疗,病变迅速改善。
该患者在记录到急性新冠感染的同时患有多灶性脉络膜视网膜炎。尽管时间上的关系可能只是偶然,但有必要将此病例告知眼科界,以观察是否还有其他类似病例。