Bilateral neurorethinovasculitis associated with COVID-19 infection in a girl 17 years old

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Abstract

Despite dominant lung lesions, new coronavirus infection (COVID-19) can influence almost any organ, including eyes. According to modern data, frequency of eye damage by COVID-19 reaches 32%, and spectrum of clinical manifestations is diverse. Changes are observed both in the anterior (mainly conjunctivitis) and posterior (mostly retinal vascular thrombosis, optic neuritis, neuroretinitis) segments of the eye, and the timing of their occurrence varies from the first (sometimes the only) clinical symptoms of the disease to the development at the peak or during the period of convalescence from COVID-19.

In children symptomatic COVID-19 infection is diagnosed less frequently than in adults, and ophthalmic manifestations are less investigated. This article describes a case of bilateral neuroretinovasculitis in a 17-year-old girl with a mild course of COVID-19, that arose 3 weeks after the onset of the disease, which broadens the understanding of ocular manifestations of COVID-19 in children.

We emphasize that an ophthalmologist should know ocular manifestations of COVID-19, which can help in the diagnosis and further study of the frequency and spectrum of ophthalmic symptoms, especially in children

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About the authors

Ekaterina Denisova

Helmholtz National Medical Research Center of Eye Diseases

Email: deale_2006@inbox.ru
ORCID iD: 0000-0003-3735-6249

PhD, researcher, department of children’s eye pathology

Russian Federation, Moscow

E. N Demchenko

Helmholtz National Medical Research Center of Eye Diseases

Email: dem-andrej@yandex.ru
ORCID iD: 0000-0001-6523-5191

PhD

Russian Federation, Moscow

Elizaveta A. Geraskina

Helmholtz National Medical Research Center of Eye Diseases

Email: slinko.amalgam@yandex.ru
ORCID iD: 0000-0002-5306-2534

graduate student

Russian Federation, Moscow

Mariia A. Khrabrova

Helmholtz National Medical Research Center of Eye Diseases

Email: lovin68@yandex.ru
ORCID iD: 0000-0001-9422-4264

graduate student

Russian Federation, Moscow

Anna Y. Panova

Helmholtz National Medical Research Center of Eye Diseases

Author for correspondence.
Email: annie_panova18@mail.ru
ORCID iD: 0000-0003-2103-1570

junior reseacher

Russian Federation, Moscow

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3. Fig. 1. Photographs of the fundus of the right (a) and left (b) eyes of patient G. during visit to Helmholtz National Medical Research Center of Eye Diseases. The optic disc is pale pink, prominates, borders are difficult to trace, epipapillary fibrosis (more on the right), parapapillary from the temporal side, subretinal fibrosis in the form of two light vertical lines, folding of the retina in the area of the papillomacular bundle, foveolar reflex is smoothed, macular reflex is absent, folding of the retina in the macula. Left — intraretinal deposits of yellowish exudate in the macula and the area of the papillomacular bundle.

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4. Fig. 2. Optical coherence tomography of the macula of the right (a) and left (b) eyes and the optic nerve disc of the right (c) and left (d) eyes of patient G. during visit to Helmholtz National Medical Research Center of Eye Diseases. Macula of both eyes — the fovea profile is preserved, retinal layers are differentiated, on the left in the nasal half of the macula — destruction of the ellipsoid zone, intraretinal hyperreflective inclusions. Central retinal thickness: on the right — 236, on the left — 213 microns. The optic nerve disc — prominence, epipapillary fibrous membrane, an increase in the thickness of the retinal nerve fibers layer parapapillary: on the right on average — 164, on the left — 217 microns.

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