COVID & CMV Retinitis

Dr. Mayank Bansal MD(AIIMS), FRCS(Glasg, UK)

Vitreo-Retinal Surgeon

2nd July 2021

In my Retina practice over last few weeks, I have seen 3 patients presenting with severe vision loss one week to one month following recovery from severe COVID pneumonia. (This is separate from the orbital mucor patients we have been managing for over more than the last month)

Findings:

• The eye and Retina examination reveals - swelling and bleeding on the retina, which we term as Viral Retinitis. Given the clinical findings, strongly resembling - Cytomegalovirus or CMV Retinitis.

• This virus, is typically found in immunocompromised patients, such as those affected with HIV / AIDS

• In one patient IgM antibodies against CMV were raised; rest didn't have the resources to test for it.

Treatment:

• CMV Retinitis is best treated using anti-viral medication, which is given orally, intravenously, or in most severe cases, by an injection inside the eye, called intra-viteal injection.

What this means:

• While this maybe a very early conclusion, the more frequent occurrence of CMV in patients recovering from COVID - may point towards the possibility that - (1) COVID leads to an immunocompromised state (2) which may be aggravated by steroid use.

What this does not mean:

• This surely does not mean that everyone with COVID may have this CMV Retinitis. Severe COVID, and use of steroids appear to be potent risk factors.

This short read is to only share a clinical experience, which may help practitioners and patients to make a decision.

(Disclaimer: This is not a medicat advice; this page only shares a practice finding, peer reviewed research papers would have a much higher level of evidence)