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Atypical unilateral multifocal choroiditis in a COVID-19 positive patient

Authors
  • de Souza, Eduardo Cunha1
  • de Campos, Vania Ewert2
  • Duker, Jay S.3
  • 1 Faculdade de Medicina Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
  • 2 Hospital de Olhos Paulista (HOlhos), Sao Paulo, Brazil
  • 3 Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
Type
Published Article
Journal
American Journal of Ophthalmology Case Reports
Publisher
Elsevier
Publication Date
Feb 19, 2021
Volume
22
Identifiers
DOI: 10.1016/j.ajoc.2021.101034
PMID: 33623832
PMCID: PMC7893242
Source
PubMed Central
Keywords
Disciplines
  • Case Report
License
Unknown

Abstract

Purpose To present a case of an atypical unilateral multifocal choroiditis that occurred in temporal association to an acute covid-19 infection. Method A 23-year-old highly myopic man presented with reduced vision in the right eye while under medical quarantine due to direct exposure to COVID-19 infection. Five days after developing mild COVID symptoms (fever, cough and anosmia) he noticed acute painless loss of central vision in his right eye. Systemic evaluation at presentation was positive for SARS-CoV-2 detected via both a pharyngeal swab and serologic titers. Dilated fundus exam was performed, followed by color fundus pictures, optic coherence tomography (OCT), fundus autofluorescence (FAF) and fluorescein angiography (FA). Results Fundoscopic examination of the right eye revealed the presence of multiple discrete, slightly elevated yellow-whitish placoid lesions at the posterior pole. The visual acuity was 20/800. The left eye was normal with 20/20 vision. The patient was placed on oral corticosteroids and the lesions rapidly improved. Conclusion The patient had an MFC chorioretinitis around the same time that he had a documented acute covid infection. Though the temporal relationship could be by chance alone, communicating this case to the ophthalmic community is warranted to see if other similar cases are noted.

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