Acute Macular Neuroretinopathy Following COVID-19 Infection: A Case Report

A 24-year-old female presented with a new scotoma in her left eye one week after testing positive for COVID-19. Fundoscopy revealed an inferonasal perifoveal retinal pigment epithelial (RPE) lesion in the left eye. Optical coherence tomography (OCT) displayed an area of outer retinal defect involving the photoreceptor layer with ellipsoid zone disruption. OCT angiography (OCTA) showed decreased reflectivity in the deep capillary plexus of the affected area. The patient was diagnosed with acute macular neuroretinopathy (AMN) and monitored without treatment. At a one-month follow-up, minimal improvement in the scotoma was noted, with OCT showing mild improvement. At four months, the scotoma remained stable, with a persistent outer retinal defect on OCT.  Despite the persistent scotoma and outer retinal defect, the patient maintained good central vision. Clinicians should be aware of potential ocular complications of COVID-19, including AMN, and monitor patients accordingly. Currently, there is no evidence-based treatment for AMN, and long-term follow-up studies are needed to better understand the prognosis and potential treatments for this condition.