Vitritis and Outer Retinal Abnormalities in a Patient with COVID-19.

Zago Filho, Luiz A; Lima, Luiz H; Melo, Gustavo B; Zett, Claudio; Farah, Michel E

PURPOSE To report a unique case of intraocular inflammation and outer retinal changes in a patient with coronavirus disease (COVID-19). CASE REPORT A 57-year-old woman was seen 12 days after COVID-19 symptoms onset confirmed by positive IgM and IgG serological tests. No anterior chamber cells were seen. Color fundus photograph showed a yellowish lesion within the macular area, and fluorescein angiography revealed hyperfluorescence on the topography of the macular lesion in both eyes. Spectral-domain optical coherence tomography demonstrated hyperreflective pinpoints at the level of posterior vitreous hyaloid, corresponding to vitritis, hyperreflective lesions at the level of inner plexiform and ganglion cell layers, and disruption of the ellipsoid zone. CONCLUSION AND IMPORTANCE COVID-19 is known to affect the inner retinal layers. The current case not only supports but also adds a vitreal and an outer retinal layer involvement that might also be caused by this infectious disease.