COVID-19-related acute macular neuroretinopathy in China: a retrospective study of 90 cases (152 eyes).

Abstract

BACKGROUND: Acute macular neuroretinopathy (AMN), a rare retinal disorder, is characterized by mild visual impairment that is associated with macular lesions. AMN cases increased during the coronavirus disease 2019 (COVID-19) pandemic. Chinese ophthalmology clinics have also observed an increase in cases since the end of 2022. We analyzed the clinical and epidemiological characteristics of COVID-19-related AMN cases in China. METHODS: This retrospective study included 90 patients (152 eyes). Information regarding COVID-19-related AMN cases was collected from online consultations and local clinics. Cases were diagnosed using multimodal fundus imaging. Statistical analyses were performed to evaluate clinical features and prognostic characteristics. RESULTS: Most patients were female (n = 70; 78%) and young (mean age, 28.6 ± 6.0 years). Bilateral AMN lesions were observed in 69% (n = 62) of patients. Most patients (n = 79; 88%) experienced a peak in ocular symptoms on the second to third day after COVID-19 symptoms, following a high fever. The most common ocular symptom was scotomas (n = 63 eyes; 41%). Most eyes (n = 112; 74%) had a baseline best-corrected visual acuity of ≥ 20/40. Among 56 patients (96 eyes) with follow-up durations of 3–15 months, changes in patient-reported visual symptoms were observed, with improvement in 41% of eyes (n = 39), no change in 46% (n = 44), and worsening in 13% (n = 13). CONCLUSIONS: Recognizing and addressing COVID-19-related retinal complications, particularly AMN, are important. Follow-up is crucial for monitoring the progression and evolution of visual symptoms and retinal changes over time.