Bilateral Acute Macular Neuroretinopathy in Acute COVID-19 Infection: A Case Study

Abstract

Introduction: Acute macular neuroretinopathy (AMN) is a rare disease of uncertain etiology that mostly affects young women. Aim: The aim of the present paper is to describe the case study of a female patient with bilateral AMN, suffering from active acute infection with COVID-19. Methods: A 32-year-old female patient with impaired vision bilaterally persisting for 2 days reported to the emergency Department of Ophthalmology at the Central Military Hospital in Ružomberok, Slovakia. The patient manifested symptoms of COVID-19 infection persisting for 3 days before the onset of visual complaints. Results: At the primary examination, initial uncorrected central visual acuity was 20/40 bilaterally, paracentral scotomas were present more in the right eye. Upon examination of the ocular fundus, the edges of the optic nerve disc were out of focus more in the left eye; brownish-red petaloid lesions were present around the fovea, the periphery was without pathological findings. OCT and OCTA were performed, with a conclusion of bilateral AMN upon a background of COVID-19 infection. Low molecular weight heparin (LMWH) was administered in a preventive dose. Conclusion: The number of documented ocular complications of COVID-19 infection, including microvascular events, is currently increasing.