Clinical Image


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

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Article ID: 101348Z01RT2022

doi: 10.5348/101348Z01RT2022CI

How to cite this article

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.

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.

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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  

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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  

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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  

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SUPPORTING INFORMATION


Author Contributions

Rika Tsukii - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Yuka Kasuya - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Shinji Makino - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Data Availability Statement

The corresponding author is the guarantor of submission.

Consent For Publication

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.

Competing Interests

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.