Focal superior quadrant haemorrhages in post COVID-19 patient: A target for personalized medicine

Eur J Ophthalmol. 2022 May;32(3):NP87-NP91. doi: 10.1177/11206721211021296. Epub 2021 Jun 4.

Abstract

Purpose: To report a case of multiple superior quadrant intraretinal haemorrhages in post-COVID-19 patient.

Case description: A 58-year-old male with a history of coronary artery disease and hypertension, presented with multiple superior quadrant intraretinal haemorrhages in the superonasal quadrant of the left eye 1 month after hospitalization for COVID-19. The right eye was normal. During his 10-day stay, he was treated with hydroxychloroquine, lopinavir + ritonavir, ceftriaxone, and his pre-existing antiplatelet therapy. During hospitalization, a complete medical work up showed an anomalous increase in D-dimer. He did not require intensive care support.

Conclusions: In this report, we focused on the origin of retinal bleeding in a post COVID-19 patient, likely due to a focal occlusion of a vessel. Considering the nature of SARS-CoV-2 infection, we hypothesize that retinal haemorrhages were caused by a combination of factors including the patient's antiplatelet therapy and the thrombotic microvascular injury caused by the virus.

Keywords: Antiplatelet therapy; COVID-19; arterial occlusion; coagulopathy; sub-internal limiting membrane haemorrhage.

Publication types

  • Case Reports

MeSH terms

  • COVID-19*
  • Humans
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Precision Medicine
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / drug therapy
  • Retinal Hemorrhage / etiology
  • SARS-CoV-2

Substances

  • Platelet Aggregation Inhibitors