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Background: Coronavirus disease (COVID-19) vaccines can cause adverse ocular effects, including vascular insults, acute macular neuroretinopathy, paracentral acute middle maculopathy (PAMM), ophthalmic vein thrombosis, Graves’ disease, arteritic anterior ischemic optic neuropathy (A-AION), and nonarteritic AION. Here, we report a case of unilateral PAMM progressing to central retinal artery occlusion (CRAO) after COVID-19 vaccination, identified using multimodal imaging. Case Presentation: A 24-year-old healthy man presented with unilateral progressive blurring of vision in the right eye. He had a recent history of fever without rashes 2 weeks after coronavirus disease vaccination. He was diagnosed with PAMM in the right eye at a local hospital and treated with a tapering dose of oral steroids. At presentation, he showed progressive blurring of vision in the right eye and the best-corrected distance visual acuity (BCDVA) was 20/60. The anterior segment was normal. Fundus examination revealed a pale optic disc with arteriolar attenuation and barrage laser scarring at the inferotemporal periphery. CRAO was diagnosed based on the right eye findings. The patient underwent multimodal imaging, including wide-field fundus photography using Optos® (Optos Carfornia®, Optos Inc., Dunfermline, United Kingdom), multicolor imaging with Spectralis™ (Heidelberg Retinal Angiograph; Heidelberg Engineering, Inc., Dossenheim, Germany), fundus fluorescence angiography (Heidelberg Retinal Angiograph; Heidelberg Engineering, Inc., Dossenheim, Germany), and optical coherence tomography angiography (ANGIOVUE, OPTOVUE, Inc., Fremont, CA, USA) using the split-spectrum amplitude-decorrelation angiography algorithm. The condition progressed from PAMM to CRAO during the oral steroid treatment course. At the 2-month follow-up, the right eye BCDVA had improved to 20/50, with fundus findings remaining the same as at the previous visit. Conclusions: This was the first report of a young patient with PAMM presenting with focal vascular occlusion that evolved to global occlusion in the form of CRAO in the absence of systemic vascular risk factors and with a normal coagulation profile. This case suggests that arterial occlusion may exert a temporary effect secondary to COVISHIELD™ vaccination. Randomized controlled trials and case – control studies on the role of vaccination in precipitating thromboembolic events in healthy individuals would provide insight into the causation.

Background: To report the posterior segment (uvea and retinal) manifestations and imaging characteristics of eyes of patients with and after coronavirus disease 2019 (COVID-19).Methods: We searched the PubMed/MEDLINE database to identify relevant articles using the following search terms: COVID-19, SARS-CoV-2, retina, uvea, optic nerve, retinal findings, posterior segment manifestations, and endophthalmitis. Articles published from December 1, 2019, to May 30, 2021, and indexed in PubMed/MEDLINE were screened.Results: For the purpose of this review, we included clinical features of 26 case reports and 8 case series. The posterior segment manifestations reported included cotton wool spots, retinal hemorrhages, central serous retinopathy, papillophlebitis, optic neuritis, panuveitis, multifocal retinitis, necrotizing retinitis, central retinal artery/vein occlusion, and Purtschner like retinopathy. In this review, we have also included optical coherence tomography angiography (OCTA) features that have been described in COVID-19 patients with pneumonia.Conclusions: COVID-19 patients can experience uveo-retinal manifestations even after recovery. These patients, even if asymptomatic for eye symptoms, should undergo an eye evaluation to rule out posterior segment involvement. OCTA performed in these patients revealed microvascular changes in the superficial and deep retinal plexuses. Some of these patients may require anticoagulant or antiplatelet therapy.

Introduction Corona virus disease (COVID-19) pandemic can cause myriad of ocular manifestations. We report a case of unilateral multi focal central serous retinopathy, post COVID-19 infection in an Asian Indian female. Case presentation A 42-year-old female presented to us with unilateral blurring, in the right eye (OD), 12 days after COVID-19 infection. She had fever, chills, shortness of breath and cough with tiredness and was COVID- RT PCR positive. She was administered intravenous and oral antibiotics with injection heparin/remdesivir, during her 7 day stay at the hospital. She was also on steroid inhalers. She had no systemic history of note. On ocular evaluation, her corrected distance visual acuity was 20/40 in OD and 20/20 in left eye (OS). Anterior segment was normal. Anterior vitreous was clear. Fundus examination of the OD showed central serous retinopathy (CSCR) with OS being normal. Conclusion CSCR can occur post COVID-19 due to steroid administration and physicians administering it should be aware of this and refer the patients to an ophthalmologist earlier.

Introduction: Corona virus disease-19 (COVID-19) infection with aggressive treatment has resulted in immunosuppression, and co-existing comorbidities that have made patients vulnerable to secondary infections including fungal infections. Purpose: We describe the clinical presentation, various diagnostic methods including in-vivo confocal microscopy features, management and clinical outcomes in Post COVID-19 fungal endophthalmitis in type II diabetics. Methods: Prospective, interventional study on two patients who recovered from COVID-19 who developed endogenous endophthalmitis presented to a tertiary eye care centre in South India. Results: Fungal infection was diagnosed based on clinical features, confocal microscopy, molecular diagnostic methods and culture methods. Two patients were treated with topical, intravitreal and systemic antifungal therapy. Conclusion: We report for the first time two cases of post COVID-19 fungal endophthalmitis in two diabetic patients with confocal features. High index of suspicion, early diagnosis, and appropriate management can improve the visual outcome in post COVID-19 fungal endophthalmitis cases.

Purpose: To quantify biomechanical change associated with autoimmune diseases using Corvis ST deformation data. Methods: Cross-sectional, observational, case control study of 76 patients with systemic autoimmune disease and 21 control subjects. All patients underwent detailed ophthalmic examination with Corvis-ST (Oculus Optikgerate Gmbh, Germany) measurements for biomechanical properties of the eye. Corneal deformation and also deformation caused by the extracorneal tissue were recorded. Using a mathematical formula, the three parameters, namely, corneal stiffness (kc), extracorneal tissue stiffness (kg), and extracorneal tissue viscosity (μg), were defined. Results: The biomechanical analysis showed that kc and μg were significantly lower in patients with systemic autoimmune disease with eye manifestations than control group. However statistically, it was significant in rheumatoid arthritis (RA) patients only. Conclusion: The new parameters, namely, kc, kg, and μg, can provide a sensitive marker of the ocular activity of the collagen vascular diseases.

Background Understanding the changes that occur in the choroid is of paramount importance in various uveitis entities. B-scan ultrasonography and indocyanine green angiography can be used to study choroid. Currently, spectral-domain optical coherence tomography is used as the standard noninvasive technique to study the choroid by enhanced depth imaging. Our aim was to study the structural visibility of the choroid using spectral-domain optical coherence tomography in the same area of interest in patients with uveitis with posterior segment manifestations using conventional, enhanced depth imaging (EDI), and combined depth imaging (CDI) techniques. Results Fifty-eight (58) eyes of 48 patients between age group 9 and 82 years were confirmed cases of uveitis. Out of the 48 patients, 21 (43.75%) were males while 27 (56.25%) were females. Sixteen eyes (27.59%) had intermediate uveitis, 33 (56.9%) had posterior uveitis, and 9 eyes (15.51%) had panuveitis. For posterior vitreous, there was substantial agreement for all the three groups (kappa value of 0.77, 0.73, and 0.72 in groups 1, 2, and 3, respectively). For vitreo retinal interface and inner choroid, there was perfect interobserver agreement, and for outer choroid, there was substantial to almost perfect interobserver agreement (kappa value of 0.71, 0.81, and 0.86 in groups 1, 2, and 3, respectively). Chi-squared test was done to compare the three groups. The method of scanning had a significant effect on the visualization of posterior vitreous and the outer choroid (p < 0.01) and did not have an effect on the visualization of vitreoretinal interface, inner retina, outer retina, and inner choroidal layers (p > 0.05). Conclusion The CDI technique alone might provide a good structural visibility compared to normal and EDI scanning done separately in patients with uveitis with posterior segment pathology. CDI OCT technique is thus able to visualize all posterior structures in a single image in patients with uveitis with posterior segment manifestations. Electronic supplementary material The online version of this article (doi:10.1186/s12348-014-0018-8) contains supplementary material, which is available to authorized users.