Ocular involvement is not uncommon in patients with Covid-19. However, the incidence of Covid-19 ophthalmopathy is unclear. The authors present a prospective case series including 2445 consecutive cases presenting at a neuro-ophthalmology clinic during the last resurgence of SARS-CoV-2 infection. From 8 December 2022 to 15 March 2023 in China, 149 cases were diagnosed as Covid-19 ophthalmopathy. The most common Covid-19 ophthalmopathy was optic neuritis (51/149), followed by acute zonal occult outer retinopathy complex disease (31/149), uveitis (17/149), ocular mobility disorder-related (third, fourth, or sixth) cranial nerve palsy (15/149), anterior ischaemic optic neuropathy (9/149), retinal artery occlusion (8/149), retinal micro-angiopathy including retinal haemorrhage and cotton wool spot (8/149), viral conjunctivitis (7/149), retinal vein occlusion (3/149), viral keratitis (2/149), ptosis (2/149), and other rare ocular diseases. Except five cases with central retinal artery occlusion, the other 144 Covid-19 ophthalmopathy cases showed good response to steroid therapy. This study revealed an incidence of 6.09% for Covid-19 ophthalmopathy in outpatients and demonstrated that SARS-CoV-2 infection could induce an initial onset or a relapse of ophthalmic diseases, and that ocular involvement might manifest as the initial or sometimes the only presentation of Covid-19.
Covid-19 ophthalmopathy
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