The data related signs of ocular fundus associated with COVID-19 published in this journal collected from December 2022, while the pandemic of COVID-19 was in a clustering occurrence. The signs of ocular fundus including acute macular neuroretinopathy (AMN), cotton wool spots or Purtscher-like retinopathy, central retinal vein occlusion (CRVO) and macular edema of unknown etiology. The different lesions can be concurrent existence in some cases is one of the clinical characteristics of COVID-19, other characteristics including both eye involved, predominated affected more women, aged from 13 to 56 years. AMN was mentioned recently in most papers on COVID-19, it has been known as deep capillary ischemia. Cotton wool spots is sign infarct in superficial capillary. Retina dots indicated retinal infarct in the outer plexiform layer. CRVO was demonstrated that the blood clot blocks the flow of blood at the level of the lamina cribro, optic disc edema with macular subretinal fluid showed the retina tissue as well as optic head affected. Eye is part of the body, lesions of ocular fundus are identical with body system. Several study proposed different hypothesis for these alterations in acute phase of COVID-19: direct viral endothelial injury, activation of the immune response by a cytokine storm leading to a procoagulant state or transient hypercoagulability. Retina lesions demonstrated a vasculature impairment in several layers of retina and edema in retina and optic disk. We should monitor in the acute phase of COVID-19 the prothrombotic markers and the treatment should consider anti-virus and preventing thrombosis formation.
Citation：
Li Xiaoxin. Manifestations of ocular fundus associated with COVID-19 indicated the important evidence for the guidance of treatments. Chinese Journal of Ocular Fundus Diseases, 2023, 39(3): 185-186. doi: 10.3760/cma.j.cn511434-20230219-00075
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Copyright © the editorial department of Chinese Journal of Ocular Fundus Diseases of West China Medical Publisher. All rights reserved
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- 1. Chen L, Liu M, Zhang Z, et al. Ocular manifestations of a hospitalised patient with confirmed 2019 novel coronavirus disease[J]. Br J Ophthalmol, 2020, 104(6): 748-751. DOI: 10.1136/bjophthalmol-2020-316304.
- 2. Sen M, Honavar SG, Sharma N, et al. COVID-19 and eye: a review of ophthalmic manifestations of COVID-19[J]. Indian J Ophthalmol, 2021, 69(3): 488-509. DOI: 10.4103/ijo.IJO_297_21.
- 3. 陈秀菊, 童毅华, 黎晓新, 等. 10例新型冠状病毒感染相关眼底病变患者的眼底影像特征[J]. 中华眼底病杂志, 2023, 39(3): 199-203. DOI: 10.3760/cma.j.cn511434-20230220-00074.Chen XJ, Tong YH, Li XX, et al. The imaging features of fundus lesions associated with COVID-19 in 10 patients[J]. Chin J Ocul Fundus Dis, 2023, 39(3): 199-203. DOI: 10.3760/cma.j.cn511434-20230220-00074.
- 4. Casalino G, Williams M, McAvoy C, et al. Optical coherence tomography angiography in paracentral acute middle maculopathy secondary to central retinal vein occlusion[J]. Eye (Lond), 2016, 30(6): 888-893. DOI: 10.1038/eye.2016.57.
- 5. Gascon P, Briantais A, Bertrand E, et al. Covid-19-associated retinopathy: a case report[J]. Ocul Immunol Inflamm, 2020, 28(8): 1293-1297. DOI: 10.1080/09273948.2020.1825751.
- 6. Virgo J, Mohamed M. Paracentral acute middle maculopathy and acute macular neuroretinopathy following SARS-CoV-2 infection[J]. Eye, 2020, 34(12): 2352-2353. DOI: 10.1038/s41433-020-1069-8.
- 7. D'Alessandro E, Kawasaki A, Eandi CM. Pathogenesis of vascular retinal manifestations in COVID-19 patients: a review[J]. Biomedicines, 2022, 10(11): 2710. DOI: 10.3390/biomedicines10112710.
