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

Table 1 Summary of 3 cases of acute macular neuroretinopathy following coronavirus disease 2019 infection

Characteristic	Case 1	Case 2	Case 3
Chief complaint	Progressive vision loss in left eye for 2 d	Blurring vision in left eye for 10 d	Sensation of occlusion in right eye for 1 wk
History of present illness	Fever for 3 d 1 wk ago, confirmed COVID-19 infection via throat swab	Fever 2 wk prior, confirmed COVID-19 infection via throat swab, not pregnant	Confirmed COVID-19 infection via nucleic acid test 2 wk prior, not pregnant
Vaccine	Inactivated COVID-19 vaccine (Vero cell, Beijing Institute of Biological Products Co., Ltd.)
BCVA	0.6 (left eye), 1.0 (right eye)	1.0 (right eye), 0.5 (left eye)	0.3 (right eye), 1.0 (left eye)
Fundus exam	Rugby ball-like lesion over macula	Scattered cotton-wool spots in both eyes
NIR	Hyporeflective lesion oriented towards fovea in left eye	Hyporeflective lesions in both eyes, pronounced in left eye	Hyporeflective lesions in right eye
OCT/ OCTA	Hyporeflective ELM, hyperreflective MZ, diminished EZ; No initial abnormalities in SCP/DCP	Hyperreflective foci in OPL, hyporeflective foci in EZ/IZ in both eyes, hyperreflective foci in INL in right eye	Hyperreflective lesions in OPL, hyporeflective lesions in EZ/IZ, hyperreflective lesions in INL
Treatment	Ibuprofen (0.2 g three times a day)	Acetaminophen (0.3 g three times a day)	Acetaminophen (0.3 g three times a day)
Final diagnosis	AMN	AMN and PAMM	AMN and PAMM

AMN: Acute macular neuroretinopathy; BCVA: Best-corrected visual acuity; COVID-19: Coronavirus disease 2019; DCP: Deep capillary plexus; ELM: External limiting membrane; EZ: Ellipsoid zone; INL: Inner nuclear layer; MZ: Myoid zone; NIR: Near-infrared reflectance imaging; OCT: Optical coherence tomography; OCTA: Optical coherence tomography angiography; PAMM: Paracentral acute middle maculopathy; SCP: Superficial capillary plexus.