ObjectiveTo observe the characteristic of optical coherence tomography (OCT) and subfoveal choroidal thickness(SFCT) in patients with multiple evanescent white dot syndrome (MEWDS). MethodsThe clinical data of 10 patients (10 eyes)with MEWDS were included in the study. 10 normal subjects with matched age, gender and ocular refractive status was selected as control. The patients including 9 females (9 eyes) and 1 male (1 eye), with the average age of (27±8) years. The onset time ranged from 5 to 14 days. The patients were in acute phase if it was in 2 weeks after onset, or convalescent phase if onset was 8 weeks ago. The corrected vision, slit lamp biomicroscopy, ophthalmoscope, fundus photography, fundus fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT) were performed alone or combined in all patients. The SFCT between the acute and convalescent phases were measured using enhanced depth imaging OCT. The average follow-up was 5 months. The OCT characteristics of affected eyes between acute and convalescent phase were compared. The SFCT of the affected eyes and fellow eye were compared. ResultsThe foveal inner segment-outer segment (IS/OS) was disrupted, thin, irregular in the acute phase, and restored in the convalescent phase. The SFCT of patients in the acute phase was (239±140.7) μm, in the convalescent phase was (189.9±115.6) μm. The SFCT in the acute phase was more thicker than the convalescent phase (t=5.287, P < 0.05). The SFCT of fellow eyes in the acute phase was (214.6±127.2) μm, in the convalescent phase was (186.5±108.6) μm, the difference was significant(t=3.553, P < 0.05).The SFCT in the control subject was (155.5±83.5) μm. The SFCT in the acute phase was thicker than the control(Z=-2.117, P < 0.05). ConclusionsIn the acute phase of MEWDS, the foveal IS/OS was disrupted, thin and irregular in OCT scan. The choroid is thicker in the acute phase than in the convalescent phase in both eyes, and thicker than controls.
Objective To observe the multimodal imaging features of retinal diseases associated with COVID-19. MethodsA retrospective case study. Sixteen patients (30 eyes) of retinal diseases associated with COVID-19 admitted to the Ophthalmology Department of the Second People's Hospital of Zhengzhou in December 2022 were included in the study. There were 5 males and 11 females, with the mean age of (26.69±9.88) years; 14 patients were bilateral and 2 patients were unilateral. The time of ocular symptoms after the diagnosis of COVID-19 was (2.63±0.89) days. All patients underwent the examinations of best corrtected visual acuity (BCVA), fundus color photography (FP), infrared fundus photography (IR), optical coherence tomography (OCT). Fluorescein fundus angiography (FFA) was performed in 2 patients (4 eyes). There were 20 eyes with acute macular neuroretinopathy (AMN), including 6 eyes with cotton wool spots; 10 eyes with Purtscher-like retinopathy (PLR). The BCVA of the patients was 0.1-1.0. No obvious abnormality was found in anterior segment examination. The features of FP, IR and OCT were analyzed retrospectively. ResultsIn 20 eyes of AMN, irregular reddish brown lesions in the central or paracentral area of the macula in 14 eyes; FP showed no obvious abnormality in 6 eyes; IR showed irregular map like low reflection in the central or paracentral area of macular in all eyes; OCT showed hyperreflectivity in outer plexiform layer and outer nuclear layer, hyporeflectivity in the ellipsoid zone and photoreceptor layers in all eyes; no abnormal fluorecence was observed in 2 eyes examined by FFA. In 10 eyes with PLR, cotton wool spots and retinal hemorrhage were observed in the posterior pole and/or peripapillary area, and the peripheral retina was generally normal, Purtscher spot was found in 5 eyes and macular edema in 4 eyes; OCT showed strong reflex signal in neuroepithelial layers, edema in neuroepithelial layers in 6 eyes; in the 2 eyes examined by FFA, fluorescein leakage from the retinal vein wall was observed, the posterior pole and peripapillary area retinal arteriole occlusions showed patchy hypofluorescence, the fluorescence was obscured by retinal hemorrhage below at inferior retina. ConclusionsFor AMN associated with COVID-19, IR can show the lesion contour , OCT shows lesions in the outer retina. PLR associated with COVID-19 are usually at the posterior pole and/or peripapillary area in FP, OCT shows neurocortical edema.