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新冠病毒感染后的匐行性脉络膜炎

Serpiginous Choroiditis After COVID-19 Infection.

作者信息

Seddigh Sorayya, Pinto Ashlyn, Zaki Amr M, Gupta R Rishi

机构信息

Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada.

出版信息

J Vitreoretin Dis. 2024 Nov 14:24741264241297936. doi: 10.1177/24741264241297936.

Abstract

To present the first case of macular serpiginous choroiditis after COVID-19 infection. A single case was analyzed. A 28-year-old previously healthy man presented with severe unilateral vision loss in the left eye. A fundus examination showed severe atrophic pigmentary changes that corresponded with optical coherence tomography (OCT) findings of a rapidly progressing amoeboid-like lesion disrupting the ellipsoid zone and retinal pigment epithelium. Multimodal imaging, including fundus autofluorescence, OCT angiography, and indocyanine green angiography, was supportive of serpiginous choroiditis. After a comprehensive systemic workup, the diagnosis of macular serpiginous choroiditis was confirmed. No improvement was seen with high-dose steroids; therefore, an immunosuppressive regimen was initiated. An exaggerated choroidal inflammatory response may be triggered by a COVID-19 infection, although causation cannot be inferred. Retinal manifestations should be considered when assessing patients presenting with visual symptoms after COVID-19 infection.

摘要

报告首例新型冠状病毒肺炎(COVID-19)感染后发生的黄斑匐行性脉络膜炎病例。分析了1例病例。一名28岁既往健康男性出现严重的左眼单眼视力丧失。眼底检查显示严重的萎缩性色素沉着改变,这与光学相干断层扫描(OCT)发现的快速进展的类阿米巴样病变破坏椭圆体带和视网膜色素上皮的结果相符。包括眼底自发荧光、OCT血管造影和吲哚菁绿血管造影在内的多模态成像支持匐行性脉络膜炎的诊断。经过全面的系统检查,黄斑匐行性脉络膜炎的诊断得到证实。高剂量类固醇治疗未见改善;因此,开始采用免疫抑制方案。尽管无法推断因果关系,但COVID-19感染可能引发过度的脉络膜炎症反应。在评估COVID-19感染后出现视觉症状的患者时,应考虑视网膜表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18d8/11562243/9bcb52632787/10.1177_24741264241297936-fig1.jpg

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