University of Health Sciences Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
Ophthalmology Department, Medipol University, Faculty of Medicine, Istanbul, Turkey.
Rom J Ophthalmol. 2024 Apr-Jun;68(2):89-91. doi: 10.22336/rjo.2024.18.
Various neurological complications have been reported after COVID-19. The study aimed to document an unusual case of Adie's tonic pupil following COVID-19. The study was a case report. A 28-year-old female had suffered a flu-like disease about 2 months before and the SARSCoV-2 polymerase chain reaction test at that time was positive. Two weeks after infection she noticed an asymmetry between the pupils. The only pathological finding on examination was anisocoria with a larger left pupil in ambient light. Light reflexes were observed in the right eye, while in the left eye, they were absent. Also, there was no near response in the left pupil. A 0.1% pilocarpine test results validated Adie's pupil diagnosis. After one year of follow-up, the anisocoria decreased but did not completely recover. COVID-19 may cause damage to neural structures due to autoimmune ways by activating immune pathways or because of vascular complications that may affect the vasa nervorum. Adie's tonic pupil is often idiopathic, but it may develop following viral infection. Ocular complications that involve pupil abnormalities may manifest following COVID-19. In the cases of Adie's tonic pupil, infectious diseases, including COVID-19, should be questioned. RT PCR = reverse transcription polymerase chain reaction.
多种神经系统并发症在新冠病毒感染后已有报道。本研究旨在记录一例新冠病毒感染后发生的 Adie 强直性瞳孔这一不常见病例。这是一项病例报告。一位 28 岁的女性大约在 2 个月前患过类似流感的疾病，当时的 SARSCoV-2 聚合酶链反应检测呈阳性。感染两周后，她注意到瞳孔不对称。检查仅发现瞳孔不等大，在环境光线下左眼瞳孔较大。右眼光反射存在，而左眼光反射消失。此外，左眼无近反射。0.1%毛果芸香碱试验结果证实了 Adie 瞳孔的诊断。随访 1 年后，瞳孔不等大有所改善，但并未完全恢复。新冠病毒可能通过激活免疫途径或血管并发症导致神经结构损伤，从而影响神经纤维血管，进而引发自身免疫反应。Adie 强直性瞳孔通常是特发性的，但也可能在病毒感染后发生。涉及瞳孔异常的眼部并发症可能在新冠病毒感染后出现。在 Adie 强直性瞳孔的情况下，包括新冠病毒感染在内的传染病应被怀疑。RT-PCR = 逆转录聚合酶链反应。
