Case report: Acute macular neuroretinopathy post-COVID-19 infection.

IF 1.6 4区 医学 Q3 OPHTHALMOLOGY
Nur Ain Mohamad, Meng Hsien Yong, Safinaz Mohd Khialdin, Mae-Lynn Catherine Bastion
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引用次数: 0

Abstract

Significance: Acute macular neuroretinopathy (AMN) is a rare disease that causes transient or permanent visual disturbance. The exact etiology remains unknown, but vascular compromise of the deep retinal capillary plexus was postulated as the main mechanism. Retinal vascular event post-coronavirus disease 2019 (COVID-19) infection is recently highlighted during the pandemic, which includes AMN.

Purpose: To report a case of AMN post-COVID-19 infection.

Case report: A 24-year-old Indian woman presented with acute-onset painless bilateral central scotoma for a day. The symptom was preceded by a history of COVID-19 infection 3 weeks prior. Ocular examination revealed a near-normal visual acuity for both eyes. Fundus examination showed bilateral dull foveal reflex with mild scattered cotton wool spot and vascular tortuosity. Optical coherence tomography macula revealed a distinct short hyperreflective band involving the outer plexiform and outer nuclear layers nasal to the fovea. The Bjerrum perimetry test revealed central scotoma temporal to the fixation. Optical coherence tomography lesions and scotomas are identical and congruous in both eyes. Serial fundus photographs are captured showing the evolving changes of near-normal macula to pigmented wedge-shaped petaloid lesions around the fovea. The patient was diagnosed as bilateral AMN and treated with oral prednisolone. On subsequent follow-up, the central scotoma improved.

Conclusions: This case illustrates a clear temporal and possible causal relationship of COVID-19 infection with AMN. Further studies and data are required to justify its association, but the rising cases of AMN shall be anticipated as COVID-19 infections have become endemic worldwide.

病例报告:感染 COVID-19 后的急性黄斑神经视网膜病变。
意义重大:急性黄斑神经视网膜病变(AMN)是一种罕见的疾病,可导致短暂或永久性视力障碍。确切的病因尚不清楚,但视网膜深层毛细血管丛的血管损害被推测为主要机制。最近,冠状病毒病 2019(COVID-19)感染后视网膜血管事件在大流行期间得到了强调,其中包括 AMN。目的:报告一例冠状病毒病 2019(COVID-19)感染后的 AMN 病例:一名 24 岁的印度女性因急性发作性双侧无痛性中心性眼睑下垂一天就诊。病例报告:一名 24 岁的印度女性因急性发作的双侧无痛性中心性视网膜病变就诊一天,在出现该症状前 3 周曾感染过 COVID-19。眼部检查显示双眼视力接近正常。眼底检查显示双侧眼窝反射迟钝,伴有轻度散在棉絮斑和血管迂曲。光学相干断层扫描黄斑显示出一条明显的短高反射带,涉及眼窝鼻侧的丛状外层和核外层。Bjerrum 近视测试显示,在定点的颞侧有中心视网膜瘤。双眼的光学相干断层扫描病变和视网膜瘤相同且一致。连续拍摄的眼底照片显示,从接近正常的黄斑到眼窝周围色素性楔形花瓣状病变的演变过程。患者被诊断为双侧 AMN,并接受了口服泼尼松龙治疗。在随后的随访中,中心视网膜灶有所改善:本病例表明,COVID-19 感染与 AMN 之间存在明确的时间和可能的因果关系。结论:本病例说明了 COVID-19 感染与 AMN 之间明显的时间关系和可能的因果关系,但由于 COVID-19 感染已成为全球流行病,AMN 病例的增加值得期待。
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来源期刊
Optometry and Vision Science
Optometry and Vision Science 医学-眼科学
CiteScore
2.80
自引率
7.10%
发文量
210
审稿时长
3-6 weeks
期刊介绍: Optometry and Vision Science is the monthly peer-reviewed scientific publication of the American Academy of Optometry, publishing original research since 1924. Optometry and Vision Science is an internationally recognized source for education and information on current discoveries in optometry, physiological optics, vision science, and related fields. The journal considers original contributions that advance clinical practice, vision science, and public health. Authors should remember that the journal reaches readers worldwide and their submissions should be relevant and of interest to a broad audience. Topical priorities include, but are not limited to: clinical and laboratory research, evidence-based reviews, contact lenses, ocular growth and refractive error development, eye movements, visual function and perception, biology of the eye and ocular disease, epidemiology and public health, biomedical optics and instrumentation, novel and important clinical observations and treatments, and optometric education.
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