Acute macular neuroretinopathy following COVID-19 infection:Three case reports  

作　　者：Chao Bi Chun-Mei Huang Ye-Qiang Shi Chao Huang Tao Yu 

机构地区：[1]Department of Ophthalmology,Jinan Second People’s Hospital,Jinan 250021,Shandong Province,China [2]Department of Ophthalmology,Central Hospital Affiliated to Shandong First Medical University,Jinan 250013,Shandong Province,China [3]Department of Ophthalmology,The First Affiliated Hospital of Shandong First Medical University,Jinan 250014,Shandong Province,China [4]School of Pharmaceutical Sciences of Shandong University,Jinan 250102,Shandong Province,China

出　　处：《World Journal of Clinical Cases》2024年第25期5775-5783,共9页世界临床病例杂志

摘　　要：BACKGROUND During the Coronavirus disease 2019(COVID-19)pandemic,a notable increase in acute macular neuroretinopathy(AMN)cases was observed.This study aimed to investigate the potential association between AMN and COVID-19 by examining 3 cases in China.CASE SUMMARY The first case involved a 30-year-old man who presented with progressive vision loss following a COVID-19 infection.Optical coherence tomography(OCT)and near-infrared imaging identified hallmark AMN lesions,hyperreflective disruptions within the outer plexiform layer,and hyporeflective anomalies in the ellipsoid zone,leading to an AMN diagnosis.Despite partial visual recovery,OCT angiography(OCTA)revealed persistent microvascular changes,specifically a decreased vascular density in the deep capillary plexus.The second case was a 24-year-old woman who experienced blurred vision and exhibited bilateral cottonwool spots on fundus examination post-COVID-19.Imaging confirmed the presence of AMN along with paracentral acute middle maculopathy(PAMM).Follow-up OCTA found a progressive reduction in vascular density,indicating ongoing microvascular compromise.The third case was a 28-year-old woman who reported sensations of occlusion in her right eye following a COVID-19 infection.Imaging confirmed both AMN and PAMM,revealing similar decreases of microvascular density on OCTA despite a significant improvement in visual acuity.We noted that all 3 patients had received the COVID-19 vaccine prior to the appearance of symptoms.CONCLUSION The findings highlight the diagnostic utility of advanced ocular imaging in detecting AMN in COVID-19 patients and the importance of comprehensive eye examinations.

关 键 词：Acute macular neuroretinopathy Paracentral acute middle maculopathy COVID-19 Optical coherence tomography Optical coherence tomography angiography Deep capillary plexus Case report 

分 类 号：R563.1[医药卫生—呼吸系统] R575[医药卫生—内科学]