A case report of a patient with panuveitis following COVID-19 infection

Abstract

Introduction: Panuveitis is intraocular inflammation of all layers of the uvea and may be isolated or associated with systemic inflammatory diseases affecting one eye or both eyes. Uveitis and conjunctivitis are noted in coronavirus disease 2019 (COVID-19) infection but have been listed as a major adverse event in case reports for COVID-19. Importance: To describe the clinical profile of a Syrian patient presenting with panuveitis following COVID-19 infection. Case presentation: A 32-year-old Syrian computer programmer, a previously healthy nonsmoker male, presented with pain, photophobia, and red eye with no irritation or discharge in eyes, decreased vision, and seeing floaters for 5 days. His only notable mention on review of systems was a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection 8 weeks prior. Ocular examination revealed panuveitis involvement. No muscle weakness or neurological positive findings were found. There was no relevant medical history or previous personal or family history. Laboratory tests, including QuantiFERON-TB, immune profile, and viral serology, were negative. Serum angiotensin-converting enzyme levels were normal. Interleukin-1 receptor was negative. Human leukocyte antigen B51/B27 typing was negative. Chest radiograph was normal. Thoracic, abdominal, and pelvic computerized tomography were normal. Based on the negative review of systems and the first panuveitis event, the presumptive diagnosis was isolated bilateral SARS-CoV-2-induced panuveitis. Clinical discussion: In December 2019, COVID-19 became a global health issue. Studies assumed that ocular manifestations of COVID-19 were rare and ranged between 3 and 30%. Moreover, it rarely happened as an initial manifestation of the disease, and it was reported during the following weeks. To our knowledge, in the literature review, panuveitis was reported after COVID infection only in our case and in Benito-Pascual et al.’s case, which described panuveitis and optic neuritis after COVID-19 infection. Conclusion: We must be aware of the possible panuveitis manifestations following COVID-19 infection.