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Acute anterior uveitis following severe acute respiratory syndrome coronavirus 2 infection

Rika Tsukii1  
,  
Yuka Kasuya1
,  
Shinji Makino1

1 Department of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, Japan

Address correspondence to:

Rika Tsukii

Department of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi,

Japan

Message to Corresponding Author


Article ID: 101348Z01RT2022

doi: 10.5348/101348Z01RT2022CI

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Tsukii R, Kasuya Y, Makino S. Acute anterior uveitis following severe acute respiratory syndrome coronavirus 2 infection. Int J Case Rep Images 2022;13(2):151–152.

ABSTRACT

No Abstract

Keywords: Acute anterior uveitis, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection

Case Report

A 45-year-old previously healthy man presented with a 4-day history of ocular pain with marked injection in the right eye two days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. He was diagnosed with COVID-19 after testing positive for SARS-CoV-2 by real-time reverse transcriptase-polymerase chain reaction using nasopharyngeal swab fluid. He was forced to stay at home because of a declaration by the Government of Japan. After a 2-week isolation period, he was referred to the Jichi Medical University Hospital. Examination revealed a best-corrected visual acuity of 20/16 and 20/20 in the right and left eyes, respectively. Intraocular pressure was 13.0 mmHg in the right eye and 12.5 mmHg in the left eye. Ocular examination revealed adhesion of the iris to the lens surface, so-called “synechia iris posterior” with ciliary injection in the right eye (Figure 1). Slit-lamp examination showed a mild inflammation in the anterior chamber with keratic precipitates, 2+ cells and 1+ flare. Fundoscopy of both eyes was unremarkable, with the optic disc appearing normal. The patient was diagnosed with acute anterior uveitis (AAU). He was treated with topical glucocorticoids and cycloplegic eye drops, and the therapeutic response was good.

Figure 1: Clinical photographs of the right eye showing adhesion of the iris to the lens surface with ciliary injection.

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Discussion

Few cases of AAU in the setting of SARS-CoV-2 infection have been reported in the literature [1],[2]. In addition, reactivation of unilateral AAU in patients who had just recovered from coronavirus disease 2019 (COVID-19) has been reported [3]. The COVID-19 pandemic has revolutionized medical and patient care practices worldwide in several fields, not just in ophthalmology [4],[5]. During the pandemic, patients are restricted from visiting an ophthalmic clinic. However, control of inflammation in uveitis often requires systemic treatment with systemic immunomodulatory therapy.

Conclusion

Although it is uncertain whether the development of AAU after SARS-CoV-2 infection was consequential or coincidental in the present case, it is necessary to provide information to recommend an appropriate consultation to prevent sight-threatening complications.

REFERENCES

1.

Mazzotta C, Giancipoli E. Anterior acute uveitis report in a SARS-CoV-2 patient managed with adjunctive topical antiseptic prophylaxis preventing 2019-nCoV spread through the ocular surface route. Int Med Case Rep J 2020;13:513–20. [CrossRef] [Pubmed]   Back to citation no. 1  

2.

Sen M, Honavar SG, Sharma N, Sachdev MS. COVID-19 and eye: A review of ophthalmic manifestations of COVID-19. Indian J Ophthalmol 2021;69(3):488–509. [CrossRef] [Pubmed]   Back to citation no. 1  

3.

Sanjay S, Mutalik D, Gowda S, Mahendradas P, Kawali A, Shetty R. Post coronavirus disease (COVID-19) reactivation of a quiescent unilateral anterior uveitis. SN Compr Clin Med 2021;3(9):1843–7. [CrossRef] [Pubmed]   Back to citation no. 1  

4.

Vu AF, Kodati S, Lin P, Bodaghi B, Emami-Naeini P; COVID-19 Practice Patterns Study Group. Impact of the COVID-19 pandemic on uveitis patient care. Br J Ophthalmol 2022;bjophthalmol-2021-320368. [CrossRef] [Pubmed]   Back to citation no. 1  

5.

Valentim CCS, Muste JC, Iyer AI, et al. Characterization of ophthalmology virtual visits during the COVID-19 pandemic. Eye (Lond) 2022;1–6. [CrossRef] [Pubmed]   Back to citation no. 1  

SUPPORTING INFORMATION

Author Contributions

Rika Tsukii - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Yuka Kasuya - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Shinji Makino - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2022 Rika Tsukii et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


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