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Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable state
INTRODUCTION: Papillophlebitis is a rare condition characterized by venous congestion and optic disc edema, which has been suggested to occur as a consequence of inflammation of the retinal veins or, possibly, the capillaries of the optic disc, leading to venous insufficiency and compression of the...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399568/ https://www.ncbi.nlm.nih.gov/pubmed/32735134 http://dx.doi.org/10.1177/1120672120947591 |
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author | Insausti-García, Alfredo Reche-Sainz, José Alberto Ruiz-Arranz, Celia López Vázquez, Ángel Ferro-Osuna, Manuel |
author_facet | Insausti-García, Alfredo Reche-Sainz, José Alberto Ruiz-Arranz, Celia López Vázquez, Ángel Ferro-Osuna, Manuel |
author_sort | Insausti-García, Alfredo |
collection | PubMed |
description | INTRODUCTION: Papillophlebitis is a rare condition characterized by venous congestion and optic disc edema, which has been suggested to occur as a consequence of inflammation of the retinal veins or, possibly, the capillaries of the optic disc, leading to venous insufficiency and compression of the central retina vein. The disease affects healthy young adults and commonly has a benign course, however, if complications such as macular edema or ischemia appears, treatment should be instituted immediately to avoid poor prognosis. CASE REPORT: A 40-year old white male patient consulted for a slight decrease in the sensitivity of the visual field in his left eye (OS). Visual acuities (VA) were 20/20 in both eyes. OS fundus examination showed dilated and tortuous retinal vessels, disc edema, and retinal hemorrhages. The patient was diagnosed with papillophlebitis. OS VA decreased to 20/200 due to macular edema, and he was treated with a intravitreal dexamethasone implant. An exhaustive and interdisciplinary exploration process was performed, identifying a recent disease and recovery of Covid-19 as the only factor of inflammation and coagulation alteration. Other systemic diseases were excluded. We also describe a rapid decrease in disc and macular edema after intravitreal dexametasone injection, which could support the inflammatory hypothesis. CONCLUSION: The importance of this case lies in the possible association of papillophlebitis with the new Covid-19 disease. We believe that the inflammatory reaction and the coagulation alteration present in our patient due to Sars-Cov2 coronavirus may have acted as risk factors for the development of papillophlebitis. |
format | Online Article Text |
id | pubmed-7399568 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-73995682020-08-04 Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable state Insausti-García, Alfredo Reche-Sainz, José Alberto Ruiz-Arranz, Celia López Vázquez, Ángel Ferro-Osuna, Manuel Eur J Ophthalmol Case Reports INTRODUCTION: Papillophlebitis is a rare condition characterized by venous congestion and optic disc edema, which has been suggested to occur as a consequence of inflammation of the retinal veins or, possibly, the capillaries of the optic disc, leading to venous insufficiency and compression of the central retina vein. The disease affects healthy young adults and commonly has a benign course, however, if complications such as macular edema or ischemia appears, treatment should be instituted immediately to avoid poor prognosis. CASE REPORT: A 40-year old white male patient consulted for a slight decrease in the sensitivity of the visual field in his left eye (OS). Visual acuities (VA) were 20/20 in both eyes. OS fundus examination showed dilated and tortuous retinal vessels, disc edema, and retinal hemorrhages. The patient was diagnosed with papillophlebitis. OS VA decreased to 20/200 due to macular edema, and he was treated with a intravitreal dexamethasone implant. An exhaustive and interdisciplinary exploration process was performed, identifying a recent disease and recovery of Covid-19 as the only factor of inflammation and coagulation alteration. Other systemic diseases were excluded. We also describe a rapid decrease in disc and macular edema after intravitreal dexametasone injection, which could support the inflammatory hypothesis. CONCLUSION: The importance of this case lies in the possible association of papillophlebitis with the new Covid-19 disease. We believe that the inflammatory reaction and the coagulation alteration present in our patient due to Sars-Cov2 coronavirus may have acted as risk factors for the development of papillophlebitis. SAGE Publications 2020-07-30 2022-01 /pmc/articles/PMC7399568/ /pubmed/32735134 http://dx.doi.org/10.1177/1120672120947591 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Reports Insausti-García, Alfredo Reche-Sainz, José Alberto Ruiz-Arranz, Celia López Vázquez, Ángel Ferro-Osuna, Manuel Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable state |
title | Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable
state |
title_full | Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable
state |
title_fullStr | Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable
state |
title_full_unstemmed | Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable
state |
title_short | Papillophlebitis in a COVID-19 patient: Inflammation and hypercoagulable
state |
title_sort | papillophlebitis in a covid-19 patient: inflammation and hypercoagulable
state |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399568/ https://www.ncbi.nlm.nih.gov/pubmed/32735134 http://dx.doi.org/10.1177/1120672120947591 |
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