Bilateral central retinal artery occlusion secondary to SARS-CoV-2 infection in the early and late periods: A case report

The causative agent of coronavirus disease (COVID-19) is a new virus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the coronavirus family. It was first detected in China in December 2019 and spread rapidly around the world. COVID-19 is highly contagious and mainly transmitted through contact with infected patients or droplets. The most common symptoms are fever, cough, weakness, muscle pain, and shortness of breath [1]. SARS-CoV-2 infects host cells through the renin angiotensin-converting enzyme 2 (ACE2) receptors. The ACE2 receptor is widely expressed in many organs, including the retina, and plays a role in the pathogenesis of systemic vascular diseases, which can lead to ocular symptoms such as diabetic and hypertensive retinopathy [2], [3]. SARS-COV-2 has been reported to be associated with neurological symptoms, including stroke, thromboembolism (e.g., pulmonary embolism), and myocardial infarction. Hypercoagulation associated with COVID-19 has been described as “sepsis-induced coagulopathy” and may predispose patients to the spectrum of thromboembolic events [4], [5], [6]. We present here the first case of bilateral central retinal artery occlusion (CRAO) that developed in the early and late stages secondary to the SARS-CoV-2 infection.