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

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.