The characteristics of multimodal fundus imaging in AMN patients following COVID infection

We investigated the features of multimodal fundus imaging in patients with both Coronavirus disease 2019 (COVID-19) and acute macular neuroretinopathy (AMN). This study included 15 patients with 29 eyes, all of whom underwent comprehensive fundus examinations and were followed for 3 months. Based on the diagnosis, patients were categorized into the AMN group and the AMN_PAMM group (AMN combined with paracentral acute middle maculopathy [PAMM]). At baseline, outer nuclear layer (ONL) thickness was not decreased in either group. However, a notable reduction in both outer retinal and full retinal thickness was observed in the AMN_PAMM group but not in the AMN group. Optical coherence tomography angiography (OCTA) demonstrated decreased vessel density (VD) in the intermediate capillary plexus (ICP) and deep capillary plexus (DCP), whereas the VD of the radial peripapillary capillary plexus (RPCP) and superficial vascular plexus (SVP) was increased in both groups. After 3 months of follow-up, ONL thickness and both outer and full retinal thickness were decreased in both groups. The VD of RPCP and SVP showed a significant decrease in the AMN_PAMM group. Visual acuity improvement was observed only in the AMN group, which may be attributed to the increase in choroid vascular index (CVI).