Bi C, Huang CM, Shi YQ, Huang C, Yu T. Acute macular neuroretinopathy following COVID-19 infection: Three case reports. World J Clin Cases 2024; 12(25): 5775-5783 [DOI: 10.12998/wjcc.v12.i25.5775]
Corresponding Author of This Article
Tao Yu, MD, Lecturer, Department of Ophthalmology, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan 250014, Shandong Province, China. rcyutao@163.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2024; 12(25): 5775-5783 Published online Sep 6, 2024. doi: 10.12998/wjcc.v12.i25.5775
Acute macular neuroretinopathy following COVID-19 infection: Three case reports
Chao Bi, Chun-Mei Huang, Ye-Qiang Shi, Chao Huang, Tao Yu
Chao Bi, Ye-Qiang Shi, Chao Huang, Department of Ophthalmology, Jinan Second People’s Hospital, Jinan 250021, Shandong Province, China
Chun-Mei Huang, Department of Ophthalmology, Central Hospital Affiliated to Shandong First Medical University, Jinan 250013, Shandong Province, China
Tao Yu, Department of Ophthalmology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
Tao Yu, School of Pharmaceutical Sciences of Shandong University, Jinan 250102, Shandong Province, China
Author contributions: Bi C and Huang CM were responsible for the ophthalmic examination of the patients and were contributors to writing the manuscript; Shi YQ analyzed and interpreted the images and was a contributor to writing the manuscript; Huang C analyzed and interpreted the images; Yu T was a major contributor to writing the manuscript; All authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tao Yu, MD, Lecturer, Department of Ophthalmology, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan 250014, Shandong Province, China. rcyutao@163.com
Received: April 7, 2024 Revised: May 22, 2024 Accepted: June 24, 2024 Published online: September 6, 2024 Processing time: 99 Days and 16.2 Hours
Abstract
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 cotton-wool 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.
Core Tip: Advanced ocular imaging has diagnostic value in identifying neuroretinopathy (AMN) in patients with Coronavirus disease 2019 (COVID-19). The clinical variability of AMN is highlighted by individual differences in the occurrence of symptoms, recovery rate, and the degree of visual improvement after COVID-19.
