Rare Fundus Lesions in Patients after COVID-19 Infection: A Cross-sectional Multicenter and Multimodal Imaging Study

Abstract

Abstract Purpose To define the characteristics of fundus manifestations in COVID-19-infected individuals with multimodal imaging techniques. Methods A cross-sectional multicenter and multimodal imaging study including 90 patients was conducted. All patients with a visual complaint occurring immediately after COVID-19 infection were referred to six clinics between December 2022 and February 2023. Demographic information and the temporal relationship between COVID-19 infection and visual symptoms were documented. The characteristics of the fundus lesions were evaluated using multimodal imaging. Results Ninety patients from 6 hospitals were enrolled in this study, including 24 males (26.67%) and 66 (73.33%) females. Seventy-eight patients (86.66%) (146 eyes) were diagnosed with AMN. The AMN patients were primarily young women (67.95%). Sixty-eight patients (87.18%) had AMN in both eyes. Thirty-eight eyes (24.36%) included Purtscher or Purtscher-like lesions. AMN lesions were evident in all OCT and IR images (100.00%). mf-ERG and VF abnormalities corresponded closely to the shape and location of the lesion images. Eleven cases were diagnosed with simple Purtscher or Purtscher-like retinopathy (2 cases, 2.22%), VKH or VKH-like uveitis (3 cases, 3.33%), MEWDS (2 cases, 2.22%), and ROCM (5 cases, 5.56%). Conclusions After COVID-19 infection, diversified fundus lesions were evident in patients with visual complaints. In this report, AMN was the dominant manifestation, followed by Purtscher or Purtscher-like retinopathy, MEWDS, VKH-like uveitis, and RCOM.