To present a case with bilateral uveitis manifesting 3 weeks after Coronavirus disease 2019 (COVID-19)
Methods
51 years old female came with the diagnosis of bilateral anterior uveitis after COVID-19. The medical history revealed chronic renal failure secondary to hypertension. On 4 March 2021 she was diagnosed with COVID-19 and hospitalized for 1 week for close follow up for her nephropathy at another center. 14 days after discharge she experienced floaters and photophobia bilaterally. She was told the have uveitis and topical corticosteroids and cycloplegic agents were prescribed. Uveitis rebounded during corticosteroid taper.
Results
Ophthalmic examination on 17 May 2021 revealed visual acuities of 0.8 OD and 0.9 OS. There were 1+ cells in the anterior chamber OU. There was mild vitritis OU. Funduscopy revealed bilateral optic disc edema and cream-orange colored spots at the level of choroid especially prominent nasally. FFA disclosed early hypofluorescent spots with late hyperfluorescence in addition to leakage from optic discs. ICGA revealed numerous hypofluorescent dots scattered all over the fundi, and hyperfluorescent patches starting around 10 minutes which coalesced at late phase. OCT disclosed disc edema.
Evaluation for sarcoidosis and tuberculosis were negative as well as HLA A29. The patient was given oral corticosteroids. Four months later the vision was 1.0 OU, and optic disc edema resolved.
Conclusion
The preliminary diagnosis in this patient is stromal choroiditis which manifested after COVID-19. Though it may be a pure coincidence, infection might have played a role in the pathogenesis by causing an immune response to the virus itself or to antigens through molecular mimicry.
Conflict of interest
No
Authors 1
Last name
KADAYIFCILAR
Initials of first name(s)
S
Department
Hacettepe University Ophthalmology Department
City
Ankara
Country
Turkey
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