Unilateral Optic Neuritis as the First and Only Manifestation of SARS-CoV-2 Infection

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the COVID pandemic. It spreads from person-to-person via direct contact or over short distances in the air, most commonly as inhaled aerosol droplets. Initial reports emphasized the effects of the virus on the respiratory system, but it quickly became recognized that SARS-CoV-2 impacts many organ systems [1]. The first report of neurologic symptoms and signs associated with SARS-CoV-2 infection was based on a retrospective series of 214 hospitalized patients in Wuhan, China [2]. Of 78 patients (36.4%) with neurological manifestations, 3 had visual loss but further details of the cause of visual loss were not given. However, since that early report, various types of neuro-ophthalmic findings have been specifically described in patients with SARS CoV-2 infection [3]. The most common afferent neuro-ophthalmic complications described are optic neuritis, papillophlebitis, papilledema.

Optic neuritis has been reported in several patients. In most of the cases, fever, cough, or other symptoms of viral infection preceded the visual loss and in one patient, pneumonitis developed after visual loss. A few patients with post-COVID optic neuritis have also demonstrated antibodies to myelin oligodendrocytic protein (MOG), suggesting an immune-mediated demyelinating event triggered by viral invasion [4], [5].

In this case report, we describe a patient who was acutely infected with SARS-CoV-2 but did not manifest any systemic or respiratory symptoms. He did develop, however, unilateral optic neuritis.

Publication History

Received: 10 October 2021

Accepted: 10 February 2022

Article published online:
26 April 2022

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