Journal of Current Glaucoma Practice

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VOLUME 16 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Rapid Onset Neovascular Glaucoma due to COVID-19-related Retinopathy

Manoj Soman, Asmita Indurkar, Thomas George, Jay U Sheth, Unnikrishnan Nair

Keywords : Central retinal artery occlusion, COVID-19, Neovascular glaucoma, Panretinal photocoagulation, Retinal vasculitis

Citation Information : Soman M, Indurkar A, George T, Sheth JU, Nair U. Rapid Onset Neovascular Glaucoma due to COVID-19-related Retinopathy. J Curr Glaucoma Pract 2022; 16 (2):136-140.

DOI: 10.5005/jp-journals-10078-1356

License: CC BY-NC 4.0

Published Online: 30-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: To present a case of rapid onset on neovascular glaucoma following the Coronavirus disease 2019 (COVID-19). Background: COVID-19 has various ocular manifestations such as conjunctivitis, uveitis, retinal vasculitis, and so on. However, to date, the development of neovascular glaucoma has not been reported in COVID-19. Case description: A 50-year-old male with a history of COVID-19 3 weeks ago presented with left eye (OS) central retinal artery occlusion (CRAO) and right eye (OD) cystoid macular edema with disc and microvascular leakage on multimodal imaging. After being managed conservatively for 2 weeks, the patient developed OD neovascular glaucoma with intraocular pressure (IOP) of 44 mm Hg and angle neovascularization (NVA) on gonioscopy. The patient was started on topical antiglaucoma medications (AGM) with panretinal photocoagulation (PRP) and responded well with complete regression of NVA, CME, and normal IOP after 3 weeks. Conclusion: This is the first reported case of rapid onset of NVG secondary to COVID-19-induced retinal vasculitis. COVID-19-associated prothrombotic state with secondary retinal vascular involvement can potentially trigger such NVG. Such NVG responds well with topical AGM and PRP therapy. Clinical significance: Given the global COVID-19 pandemic, it is imperative to be vigilant regarding the various vision-threatening manifestations associated with the disease such as the NVG.

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  1. Klok FA, Kruip MJHA, Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020;191:145–147. DOI: 10.1016/j.thromres.2020.04.013
  2. Sen M, Honavar SG, Sharma N, et al. COVID-19 and eye: a review of ophthalmic manifestations of COVID-19. Indian J Ophthalmol 2021;69:488–509. DOI: 10.4103/ijo.IJO_297_21
  3. Shazly TA, Latina MA. Neovascular glaucoma: etiology, diagnosis and prognosis. Semin Ophthalmol 2009;24(2):113–121. DOI: 10.1080/08820530902800801
  4. Hayreh SS. Neovascular glaucoma. Prog Retin Eye Res 2007;26(5):470–485. DOI: 10.1016/j.preteyeres.2007.06.001
  5. Rodrigues GB, Abe RY, Zangalli C. et al. Neovascular glaucoma: a review. Int J Retin Vitr 2016;14(2):26. DOI: 10.1186/s40942-016-0051-x.
  6. Senthil S, Dada T, Das T, et al. Neovascular glaucoma - a review. Indian J Ophthalmol 2021;69(3):525–534. DOI: 10.4103/ijo.IJO_1591_20
  7. Chen L, Deng C, Chen X, et al. Ocular manifestations and clinical characteristics of 535 cases of COVID-19 in Wuhan, China: a cross-sectional study. Acta Ophthalmol 2020;98(8):e951–e959. DOI: 10.1111/aos.14472
  8. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382(18):1708–1720. DOI: 10.1056/NEJMoa2002032
  9. Güemes-Villahoz N, Burgos-Blasco B, García-Feijoó J, et al. Conjunctivitis in COVID-19 patients: frequency and clinical presentation. Graefes Arch Clin Exp Ophthalmol 2020;258(11):2501–2507. DOI: 10.1007/s00417-020-04916-0
  10. Tisdale AK, Chwalisz BK. Neuro-ophthalmic manifestations of coronavirus disease 19. Curr Opin Ophthalmol 2020;31(6):489–494. DOI: 10.1097/ICU.0000000000000707
  11. Sawalha K, Adeodokun S, Kamoga GR. COVID-19 induced acute bilateral optic neuritis. J Investig Med High Impact Case Rep 2020;8:2324709620976018. DOI: 10.1177/2324709620976018
  12. Walinjkar JA, Makhija SC, Sharma HR, et al. Central retinal vein occlusion with COVID-19 infection as the presumptive etiology. Indian J Ophthalmol 2020;68(11):2572–2574. DOI: 10.4103/ijo.IJO_2575_20
  13. Sheth JU, Narayanan R, Goyal J, et al. Retinal vein occlusion in COVID-19: a novel entity. Indian J Ophthalmol 2020;68(10):2291–2293. DOI: 10.4103/ijo.IJO_2380_20
  14. Gaba WH, Ahmed D, Al Nuaimi RK, et al. Bilateral central retinal vein occlusion in a 40year old man with severe coronavirus disease 2019 (COVID-19) pneumonia. Am J Case Rep 2020;21:e927691-1–e927691-5. DOI: 10.12659/AJCR.927691
  15. Acharya S, Diamond M, Anwar S, et al. Unique case of central retinal artery occlusion secondary to COVID-19 disease. IDCases 2020;21:e00867. DOI: 10.1016/j.idcr.2020.e00867
  16. Dumitrascu OM, Volod O, Bose S, et al. Acute ophthalmic artery occlusion in a COVID-19 patient on apixaban. J Stroke Cerebrovasc Dis 2020;29(8):104982. DOI: 10.1016/j.jstrokecerebrovasdis.2020.104982
  17. Zapata MÁ, Banderas García S, Sánchez-Moltalvá A, et al. Retinal microvascular abnormalities in patients after COVID-19 depending on disease severity. Br J Ophthalmol 2020;bjophthalmol-2020-317953. DOI: 10.1136/bjophthalmol-2020-317953
  18. Becker RC. COVID-19-associated vasculitis and vasculopathy. Journal of thrombosis and thrombolysis 2020;50(3):499–511. DOI: 10.1007/s11239-020-02230-4
  19. Insausti-García A, Reche-Sainz JA, Ruiz-Arranz C, et al. Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable state. Eur J Ophthalmol 2022;32(1):NP168–NP172. DOI: 10.1177/1120672120947591
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