Optic neuritis concomitant with pituitary macroadenoma in a patient with active COVID-19 infection: A case report. (September 2021)

• Record Type: Journal Article
• Authors: Al-Salihi, Mohammed Maan; Rahman, Md Moshiur; Al-Jebur, Maryam Sabah; Rahman, Sabrina; Lozada-Martinez, Ivan David; Rahman, Raphia; Moscote-Salazar, Luis Rafael
• Is Part Of: International journal of surgery open. Volume 35(2021)
• Publication Date: 2021-09
• Subjects: COVID-19 -- Optic neuritis -- Pituitary macroadenoma; Surgery -- Periodicals; 617.005
• DOI: 10.1016/j.ijso.2021.100390
• Languages: English
• ISSNs: 2405-8572

Abstract

Abstract: Introduction and importance: Several neuro-ophthalmic manifestations have been reported with coronavirus disease 2019 (COVID-19) infection. However, isolated optic neuritis was infrequently reported in humans with COVID-19. If it occurred, optic neuritis was usually a part of a demyelinating syndrome. Case presentation: In this paper, we report a case of optic neuritis concomitant with an undiagnosed pituitary macroadenoma discovered during active COVID-19 infection. The case was a 33-year-old woman with infertility who was recently found to have a pituitary macroadenoma secreting prolactin. During active COVID-19 infection, the patient developed optic neuritis that responded well to corticosteroids. Brain imaging and hormonal profile negated the presence of any demyelinating disease or pituitary apoplexy. Clinical discussion: A dilemma of whether optic neuritis occurring concomitantly with pituitary macroadenoma is just a coincidence, or there is an association remains unresolved. Whether COVID-19 infection might precipitate optic neuritis in patients with pituitary macroadenoma or not remains an issue to be answered by observing data from future case reports about similar findings. Conclusion: Optic neuritis in concomitant with pituitary macroadenoma following COVID-19 infection represents a dilemma of whether the visual symptoms are attributed to the tumor or COVID-19 infection. Highlights: A case of optic neuritis concomitant with an undiagnosed pituitary macroadenoma was discovered during COVID-19 infection. During active COVID-19 infection, the patient developed optic neuritis that responded well to corticosteroids. The pituitary macroadenoma was surgically removed successfully via the endonasal transsphenoidal approach. COVID-19 might precipitate optic neuritis in patients with pituitary macroadenoma, an issue to be resolved in the future.