Optic neuritis concomitant with pituitary macroadenoma in a patient with active COVID-19 infection: A case report

Int J Surg Open. 2021 Sep;35:100390. doi: 10.1016/j.ijso.2021.100390. Epub 2021 Aug 25.

ABSTRACT

INTRODUCTION AND IMPORTANCE: Several neuro-ophthalmic manifestations have been reported with coronavirus disease 2019 (COVID-19) infection. However, isolated optic neuritis was infrequently reported in humans with COVID-19. If it occurred, optic neuritis was usually a part of a demyelinating syndrome.

CASE PRESENTATION: In this paper, we report a case of optic neuritis concomitant with an undiagnosed pituitary macroadenoma discovered during active COVID-19 infection. The case was a 33-year-old woman with infertility who was recently found to have a pituitary macroadenoma secreting prolactin. During active COVID-19 infection, the patient developed optic neuritis that responded well to corticosteroids. Brain imaging and hormonal profile negated the presence of any demyelinating disease or pituitary apoplexy.

CLINICAL DISCUSSION: A dilemma of whether optic neuritis occurring concomitantly with pituitary macroadenoma is just a coincidence, or there is an association remains unresolved. Whether COVID-19 infection might precipitate optic neuritis in patients with pituitary macroadenoma or not remains an issue to be answered by observing data from future case reports about similar findings.

CONCLUSION: Optic neuritis in concomitant with pituitary macroadenoma following COVID-19 infection represents a dilemma of whether the visual symptoms are attributed to the tumor or COVID-19 infection.

PMID:34568623 | PMC:PMC8384762 | DOI:10.1016/j.ijso.2021.100390

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