Serpiginous choroiditis presenting after SARS-CoV-2 infection: A new immunological trigger?. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Providência, Joana; Fonseca, Cristina; Henriques, Filipe; Proença, Rui
• Is Part Of: European journal of ophthalmology. Volume 32:Issue 1(2022)
• Page Start: NP97
• Page End: NP101
• Publication Date: 2022-01
• Subjects: Posterior uveitis -- uveitis -- immunology -- choroidal/retinal Inflammation -- uvea -- techniques of retinal examination -- retina -- complications of uveitis; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.1177/1120672120977817
• Languages: English
• ISSNs: 1120-6721

Abstract

Introduction: To report the first case of a serpiginous choroiditis presenting after SARS-CoV-2 infection in a previously healthy young woman. Case description: A 41-year-old woman reported blurry vision OS 1 month after a mild SARS-CoV-2 infection. Left eye fundus examination revealed multiple peripapillary atrophic lesions, adjacent to a larger diffuse, ill-defined, yellow-whitish deep amoeboid-like patch, involving the peripapillary region and extending temporally to the fovea. Multimodal imaging including fluorescein angiography, indocyanine-green angiography, fundus autofluorescence and optical coherence tomography was consistent with serpiginous choroiditis. A complete systemic work-up was performed to exclude potential infectious or inflammatory etiologies. The active choroidal lesions responded to high dose corticosteroids, with functional improvement. Immunomodulatory therapy with methotrexate was initiated for long-term management. Conclusion: Serpiginous choroiditis is a rare but important sight-threatening condition that has been previously associated to viral infections, which seem to have a role in the induction and/or perpetuation of choroidal inflammation. SARS-CoV-2 infection appears to have played a role as a possible trigger for intraocular inflammation in this case. Therefore, COVID-19 patients reporting visual symptoms should be carefully evaluated in order to obtain adequate ophthalmological management to avoid irreversible visual damage.