Rony C Preti1, Leandro C Zacharias1, Leonardo P Cunha1,2, Mario L R Monteiro1. 1. Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil; and. 2. Department of Ophthalmology, Federal University of Juiz de Fora Medical School, Juiz de Fora, Minas Gerais, Brazil.
Abstract
PURPOSE: To describe a case of sudden visual loss from acute macular neuroretinopathy (AMN) as the presenting manifestation of active COVID-19 infection. CASE REPORT: During the quarantine period of the COVID-19 pandemic, a 70-year-old man presented with a 1-day history of a paracentral scotoma of the left eye associated with diaphoresis. Four days later, the patient developed fever (38°C) followed by cough. Oral and nasal swab PCR testing was positive for COVID-19. Visual acuity in the day of presentation was 20/20 in the right eye and 20/100 in the left eye. Multimodal retinal imaging was unremarkable in the right eye, but cross-sectional optical coherence tomography displayed focal hyperreflectivity at the level of the outer nuclear layer associated with disruption of the ellipsoid zone. The corresponding en face optical coherence tomography revealed an inferonasal hyperreflective parafoveal lesion. At 1 month of follow-up, tracked optical coherence tomography of the macula showed resolution of the hyperreflective signal, thinning of the outer nuclear layer, and near-complete recovery of ellipsoid zone integrity. CONCLUSION: Patients with COVID-19 may rarely present with signs and symptoms of ocular disease. This case report describes a case of sudden visual loss caused by acute macular neuroretinopathy as the presenting manifestation of active COVID-19 infection.
PURPOSE: To describe a case of sudden visual loss from acute macular neuroretinopathy (AMN) as the presenting manifestation of active COVID-19 infection. CASE REPORT: During the quarantine period of the COVID-19 pandemic, a 70-year-old man presented with a 1-day history of a paracentral scotoma of the left eye associated with diaphoresis. Four days later, the patient developed fever (38°C) followed by cough. Oral and nasal swab PCR testing was positive for COVID-19. Visual acuity in the day of presentation was 20/20 in the right eye and 20/100 in the left eye. Multimodal retinal imaging was unremarkable in the right eye, but cross-sectional optical coherence tomography displayed focal hyperreflectivity at the level of the outer nuclear layer associated with disruption of the ellipsoid zone. The corresponding en face optical coherence tomography revealed an inferonasal hyperreflective parafoveal lesion. At 1 month of follow-up, tracked optical coherence tomography of the macula showed resolution of the hyperreflective signal, thinning of the outer nuclear layer, and near-complete recovery of ellipsoid zone integrity. CONCLUSION: Patients with COVID-19 may rarely present with signs and symptoms of ocular disease. This case report describes a case of sudden visual loss caused by acute macular neuroretinopathy as the presenting manifestation of active COVID-19 infection.
Authors: Vittorio Capuano; Paolo Forte; Riccardo Sacconi; Alexandra Miere; Carl-Joe Mehanna; Caterina Barone; Francesco Bandello; Eric H Souied; Giuseppe Querques Journal: Eur J Ophthalmol Date: 2022-03-31 Impact factor: 2.597
Authors: Russel H Dinh; Edmund Tsui; Matthew S Wieder; Alexander Barash; Michael M Park; Ehsan Rahimy; Prithvi Mruthyunjaya; Louise J Lu; Suzanne M Michalak; Rohan J Shah; David Sierpina; Timothy W Winter; Ryan A Shields; Eduardo Uchiyama; Gregory D Lee; Rahul Komati; Eric Lee; Sundeep K Kasi; Brian K Do Journal: Ophthalmol Retina Date: 2022-10-07