Unilateral acute posterior multifocal placoid pigment epitheliopathy in a convalescent COVID-19 patient

Abstract

Background: To report a case of unilateral acute posterior multifocal placoid pigment epitheliopathy (APMPPE) in a Hispanic convalescent COVID-19 female patient. Case presentation A 35-year-old Hispanic female with exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was evaluated due to unilateral visual loss. Ophthalmic examination and diagnostic tests were consistent with APMPPE.

Discussion: Ocular changes can be observed in patients with COVID-19. A complete ophthalmic evaluation must be performed in patients with low vision after SARS-CoV-2 infection.

Keywords: Acute posterior multifocal placoid pigment epitheliopathy; Coronavirus disease 2019; Severe acute respiratory syndrome coronavirus 2.

Figure. 1

Fundus multimodal imaging of a patient with serological evidence of SARS-CoV-2 exposure. A, B: color fundus photographs showing multiple yellow–white placoid lesions involving the fovea in the right eye. Left eye posterior segment is unremarkable. C–D: fluorescein angiography demonstrates early hypofluorescence with hyperfluorescent staining of all lesions. E: normal fluorescein angiogram in the LE. F: fundus autofluorescence showing hypoautofluorescent lesions surrounded by a hyperautofluorescent halo in the right eye. G: fundus autofluorescence shows isoautofluorescence in the left eye. H–I: cross-sectional optical coherence tomography (OCT) scans in extrafoveal lesions demonstrate hyper-reflective material at the level of the outer retinal layers. Disruption of the interdigitation zone and hyper-reflective material is observed at the foveal depression