Retinal Vein Occlusions Associated with COVID-19 Infection

A study aimed to discern a potential association between COVID-19 infection and hemi retinal vein occlusions (HRVO) and central RVO (CRVO) in healthy patients under the age of 50 years. The results were presented at the American Society of Retina Specialists (ASRS) 2021 Annual Meeting.

“Venous thromboembolic complications and coagulation abnormalities have been widely reported in association with COVID-19 infection,” the researchers wrote.

This multi-center, retrospective, non-consecutive study was conducted between March 2020 and March 2021 and comprised 11 eyes (n = 11) with CRVO (n = 8, 73%) or HRVO (n = 3, 27%) following COVID-19 infection. Any patients aged over 50 years, who had a history of hypertension, diabetes, glaucoma, or obesity, presented with branch RVO or retinal artery occlusions, or required intubation during COVID-related hospitalization were excluded from the analysis.

According to the results, presenting visual acuity (VA) ranged from 20/20 to counting fingers (CF), with most eyes (64%) having ≥20/40 VA. Hypercoagulable workup was negative in all cases. Optical coherence tomography identified macular edema at presentation in 36% of eyes, while 73% of eyes were observed without treatment, and 27% received intravitreal anti-vascular endothelial growth factor (VEGF) injections. The researchers noted that all eyes had partial or complete resolution of CRVO/HRVO at final follow up. Macular edema resolved in all cases, three quarters of which required anti-VEGF treatment. Final VA ranged from 20/20 to 20/40, with all 11 eyes achieving ≥20/40 VA eyes at final follow-up.

“While we acknowledge a high seroprevalence of COVID-19 exists and that a causal relationship cannot be established, we report this series to raise awareness of the potential risk of retinal vascular events due to a heightened thrombo-inflammatory state associated with COVID-19 infection,” the researchers concluded. “Our series demonstrates these eyes have good visual prognosis with minimal intervention.”

Source: Ashkenazy N, et al. Retinal Vein Occlusions Associated with COVID-19 Infection. Published for ASRS 2021; October 8-12, 2021, San Antonio, TX.