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Figure 5: Acute macular neuroretinitis (AMN) and paracentral acute middle maculopathy (PAMM) as a manifestation of COVID-19: A 32-yearold male presented with abrupt onset paracentral triangular negative scotoma in his right eye noted below and to the right side of the centre of his visual field. History was significant for recovery from COVID-19 infection recently. Left eye was asymptomatic. (a) Fundus evaluation of the right eye revealed a triangular greyish-white lesion in deeper retina superonasal to the macular centre. (b) Optical coherence tomography (OCT) revealed corresponding areas of disruption in the outer retinal layers in addition to (c) other hyper-reflective lesions in more superficial retinal layers causing shadowing in underlying deeper retina. (d)There was hyper-reflectivity of the entire inner retinal surface just inferior to foveal centre. (e)Left eye fundus examination revealed a small whitish lesion nasal to foveal centre and multiple smaller lesions inferonasal and temporal to centre; (e) OCT revealed a single hyper-reflective lesion in the superficial retina with shadowing temporal to centre and (g) hyperreflectivity of the entire inner retinal surface nasal to centre. These findings suggested post-COVID-19 right eye symptomatic AMN and bilateral asymptomatic PAMM. (Contributed by Mallika Goyal, Retina-Vitreous Service, Apollo Eye Institute, Apollo Hospitals, Hyderabad, India) |
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