| Autor: |
Mbekeani JN; Department of Surgery (Ophthalmology), Jacobi Medical Center, Bronx, NY.; Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY., Raval NK; Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY., Vo TA; Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY., Rusu IM; Department of Surgery (Ophthalmology), Jacobi Medical Center, Bronx, NY.; Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.; Brooklyn Eye Center, Brooklyn NY., Lin SZ; Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY., Coyle CM; Department of Medicine (Infectious Diseases), Jacobi Medical Center, Bronx, NY.; Department of Medicine (Infectious Diseases), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY., Hoffman JP; Department of Medicine (Infectious Diseases), Jacobi Medical Center, Bronx, NY.; Department of Medicine (Infectious Diseases), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. |
| Abstrakt: |
The most frequently reported ophthalmic manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is conjunctivitis. We have described a case of Purtscher-like retinopathy in a patient with severe coronavirus disease 2019 (COVID-19)-associated coagulopathy. A young woman with multiple comorbidities was admitted for COVID-19-related acute respiratory distress syndrome. Her course was complicated by fungemia. Ophthalmic examination revealed bilateral posterior pole, intraretinal lesions and fluconazole was added for presumed fungal retinitis. At 1-week follow-up, widespread peripapillary cotton-wool spots and hemorrhages suggestive of Purtscher-like retinopathy were observed. The levels of D-dimers, fibrinogen, and C-reactive protein were markedly elevated prior to our consultation, indicating preceding prothrombotic and pro-inflammatory states. Subsequent venous duplex revealed deep venous thrombosis in the right subclavian and internal jugular veins. Von Willebrand factor indices were markedly elevated, suggesting severe COVID-19-associated coagulopathy. Purtscher-like retinopathy, a rare occlusive microangiopathy has been described in various pro-inflammatory and prothrombotic conditions. To the best of our knowledge, this is the first report of Purtscher-like retinopathy in COVID-19-associated coagulopathy. |
