COVID-19 and optic neuritis: a series of three cases and a critical review

• Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery Vol. 59; no. 1; pp. 172 - 6
• Main Authors: Chakraborty, Uddalak, Chaudhuri, Jasodhara, Datta, Amlan Kusum, Mukherjee, Adreesh, Pandit, Alak, Ray, Biman Kanti, Gangopadhyay, Goutam
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 20.12.2023; Springer Nature B.V; SpringerOpen
• Subjects: Case Report; Coronaviruses; COVID-19; Medicine; Medicine & Public Health; MOG; Molecular mimicry; Neurology; Neurosurgery; Optic neuritis; Parainfectious; Postinfectious; Psychiatry; COVID-19; Parainfectious; Molecular mimicry; MOG; Postinfectious; Optic neuritis
• ISSN: 1110-1083; 1687-8329
• DOI: 10.1186/s41983-023-00772-x

Background The novel coronavirus disease (COVID-19) has claimed innumerable lives globally since its onset and several extrapulmonary manifestations of the disease have been reported in association with COVID-19. Although optic neuropathy has been previously linked to a variety of infections, neuro-ophthalmological associations of SARS-CoV-2 have been sparsely reported till date. Our aim was to report the clinical profile and outcome of patients diagnosed with parainfectious/postinfectious optic neuritis (ON) associated with COVID-19. Case presentation In this case series, we have discussed the clinical presentation, laboratory parameters and outcome in a series of three patients of ON associated with COVID-19 and also compared those findings against existing literature. Among the three patients, two patients (Case 1, 3) were incidentally diagnosed with COVID-19 during the course of hospital admission and contributed to a parainfectious association with ON, while one patient (Case 2) had an antecedent history of COVID-19 as evidenced by her antibody titers thus contributing to a postinfectious association. Notably, all these patients were asymptomatic or had mild manifestations of COVID-19 and all of them tested negative for myelin oligodendrocyte glycoprotein (MOG) antibodies. They were treated accordingly and their visual outcomes were noted in follow-up. Conclusion ON with or without MOG seropositivity, probably attributed to molecular mimicry has surfaced up considerably in association with COVID-19. This article provides a comprehensive overview of clinical presentation and outcome of ON associated with parainfectious/postinfectious COVID-19 in three cases and a critical analysis of existing literature.