Turedi N, Onal Gunay B. Paracentral acute middle maculopathy in the setting of central retinal artery occlusion following COVID-19 diagnosis.
Eur J Ophthalmol 2021;
32:NP62-NP66. [PMID:
33583231 PMCID:
PMC9111906 DOI:
10.1177/1120672121995347]
[Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background:
Since its emergence in Wuhan, China, COVID-19 has disseminated across many
other countries worldwide. In this report, we firstly presented a patient
with mild COVID-19 disease who developed paracentral acute middle
maculopathy (PAMM) due to CRAO.
Case presentation:
A 54-year-old male patient who reported a contact with a COVID-19 patient
applied to the hospital and tested positive for SARS-CoV-2 by polimerase
chain reaction testing. He had no significant past medical history. Chest
computed tomography was not notable. He had a mild COVID-19 course during
hospitalization. Two weeks following COVID-19 diagnosis, he reported profund
vision loss (counting fingers) in his right eye where central retinal artery
occlusion (CRAO) was detected on fundoscopic examination. Coagulation
profile was within normal limits. Hypercoagulable work up was also not
notable. Treatment was given for CRAO. Visual acuity was counting fingers at
30 cm. Five days following treatment. Optical coherence tomography analysis
showed increased diffuse reflectance and thickening at the level of inner
nuclear layer consistent with PAMM. Fluorescein angiography illustrated no
perfusion defect.
Conclusion:
This is the first case that reports PAMM in the setting of CRAO following
COVID-19 diagnosis. Viral induced microangiopathy may involve in the
development of CRAO in our patient without a hypercoagulable state and
additional risk factors. Physicians should be vigilant to seek for retinal
evaluation in patients with significant visual loss even after a mild
COVID-19 history.
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