Focal superior quadrant haemorrhages in post COVID-19 patient: A target for personalized medicine

Abstract

Purpose:

To report a case of multiple superior quadrant intraretinal haemorrhages in post-COVID-19 patient.

Case description:

A 58-year-old male with a history of coronary artery disease and hypertension, presented with multiple superior quadrant intraretinal haemorrhages in the superonasal quadrant of the left eye 1 month after hospitalization for COVID-19. The right eye was normal. During his 10-day stay, he was treated with hydroxychloroquine, lopinavir + ritonavir, ceftriaxone, and his pre-existing antiplatelet therapy. During hospitalization, a complete medical work up showed an anomalous increase in D-dimer. He did not require intensive care support.

Conclusions:

In this report, we focused on the origin of retinal bleeding in a post COVID-19 patient, likely due to a focal occlusion of a vessel. Considering the nature of SARS-CoV-2 infection, we hypothesize that retinal haemorrhages were caused by a combination of factors including the patient’s antiplatelet therapy and the thrombotic microvascular injury caused by the virus.

Keywords

Antiplatelet therapy arterial occlusion coagulopathy COVID-19 sub-internal limiting membrane haemorrhage

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