Úvod: Akútna makulárna neuroretinopatia (AMN) je raritné ochorenie, neistej etiológie, ktoré najčastejšie postihuje mladé ženy. Cieľ: Cieľom práce je popísať kazuistiku pacientky s bilaterálnou AMN pri aktívnej akútnej infekcii COVID-19. Metodika: 32ročná pacientka s 2 dňovou anamnézou zhoršeného videnia bilaterálne prichádza na pohotovosť očnej kliniky Ústrednej vojenskej nemocnice SNP v Ružomberku, Slovensko. Symptomatika infekcie COVID-19 v trvaní 3 dni pred nástupom vizuálnych ťažkostí. Výsledky: Pri primárnom vyšetrení vstupná centrálna zraková ostrosť bilaterálne 20/40 nekoriguje, prítomné paracentrálne skotómy viac vpravo. Pri vyšetrení očného pozadia zneostrené okraje terča zrakového nervu viac vľavo, okolo fovey prítomné hnedočervené petaloidné lézie, periféria bez patologického nálezu. Realizované OCT a OCTA so záverom bilaterálnej AMN pri infekcii COVID-19 s nasadením nízkomolekulárneho heparínu (LMWH) v preventívnej dávke. Záver: V súčasnej dobe pribúda počet zdokumentovaných očných komplikácií infekcie COVID-19 vrátane mikrovaskulárnych príhod.
Aim: The aim of the present paper is to describe the case study of a female patient with bilateral AMN, suffering from active acute infection with COVID-19. Methods: A 32-year-old female patient with impaired vision bilaterally persisting for 2 days reported to the emergency Department of Ophthalmology at the Central Military Hospital in Ružomberok, Slovakia. The patient manifested symptoms of COVID-19 infection persisting for 3 days before the onset of visual complaints. Results: At the primary examination, initial best corrected central visual acuity was 20/40 bilaterally, paracentral scotomas were present more in the right eye. Upon examination of the ocular fundus, the edges of the optic nerve disc were out of focus more in the left eye; brownish red petaloid lesions were present around the fovea, the periphery was without pathological findings. OCT and OCTA were performed, with a conclusion of bilateral AMN upon a background of COVID-19 infection. Low molecular weight heparin (LMWH) was administered in a preventive dose. Conclusion: The number of documented ocular complications of COVID-19 infection, including microvascular events, is currently increasing.
- MeSH
- COVID-19 * diagnóza komplikace MeSH
- dospělí MeSH
- heparin nízkomolekulární farmakologie terapeutické užití MeSH
- lidé MeSH
- syndromy bílých teček * diagnóza etiologie MeSH
- výsledek terapie MeSH
- zrakové testy metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Aims: To introduce a case report and review the literature on trauma-related acute macular neuroretinopathy as an unusual etiology of acute macular neuroretinopathy. Material and Methods: A 24-year-old man presented with unilateral paracentral scotoma following non-ocular trauma in a car accident. The relative afferent pupillary defect was negative and the best corrected visual acuities of both eyes were 10/10 (by the Snellen chart scale). Results: Retinoscopy revealed a reduced foveal reflex, along with a small pre-retinal hemorrhage over the mid-pathway of the supranasal arteriole. OCT images showed an obvious ellipsoid zone (EZ) layer disruption in the macula of the left eye. The infrared fundus photograph of the same eye revealed a distinct hyporeflective area involving the macula. On fundus angiography, no macular vascular lesion was detected. The scotoma persisted after 3 months follow-up. Conclusion: Non-ocular trauma including head or chest trauma without direct ocular injury accounts for most cases of trauma-related acute macular neuroretinopathy. It is important to distinguish this entity, given that there are also unremarkable findings in the retinal examination of these patients. Indeed, proper clinical suspicion leads to further suitable investigations and impedes other extraordinary images, which are the basic rules in the management of traumatic patients suffering multiple injuries and incurring medical expenses.
- MeSH
- dopravní nehody MeSH
- fluoresceinová angiografie metody MeSH
- lidé MeSH
- macula lutea patologie MeSH
- mladý dospělý MeSH
- optická koherentní tomografie metody MeSH
- rány a poranění komplikace MeSH
- retinální krvácení etiologie MeSH
- skotom etiologie komplikace MeSH
- syndromy bílých teček * diagnóza etiologie MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
