ABSTRACT
AIM: To observe the clinical features of acute macular neuroretinopathy(AMN)induced by Omicron.METHODS: A retrospective study. A total of 9 patients(18 eyes)diagnosed with AMN from December 2022 to January 2023 in the Hospital of Chengdu University of Traditional Chinese Medicine were included. Patients underwent spectral-domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), fundus photography, autofluorescence(AF), infrared reflectance(IR), optical coherence tomography angiography(OCTA)and multicolor, etc. Furthermore, they were followed up for 1～3mo and observed the prognosis.RESULTS: The initial symptom of the Omicron-induced AMN was the sudden onset of central/paracentral scotoma in the eyes with or without impaired vision and metamorphopsia, and the scotoma could persist for at least 3mo. The image features of AMN are as follows. First, the SD-OCT examination showed the rupture of outer retinal layers, scattered hyperreflective lesions, and atrophy of outer retinal layers. In severe cases, hyperreflective lesions were seen in the inner nuclear layer(INL)or with microcystic cavities under the retinal pigment epithelium(RPE). Second, the OCTA examination demonstrated the decreased blood flow density of the deep capillary plexus(DCP)of the macula. Third, the IR examination showed the weak reflection of lesion areas. Fourth, the fundus photography demonstrated the localized brown wedge-shaped lesion.CONCLUSIONS: The Omicron-induced AMN is mostly found in young females, and the characteristic manifestation of fundus is damage to the outer retinal layers. The extent of fundus lesions is related to the systemic inflammatory response and ocular microcirculatory changes after infection. The multimodal fundus image examination and a history of Omicron infection are helpful to diagnose the Omicron-induced AMN.
ABSTRACT
@#Diabetic retinopathy(DR)is one of the chronic microvascular complications of diabetes mellitus in the eye, leading to an increasing incidence of visual quality loss and even blindness in diabetic patients. However, so far, the mechanism of pathological changes leading to DR is very complex and not completely elucidated, and clinical treatment is mostly based on different stages of DR with symptomatic treatment, such as retinal laser photocoagulation, anti-vascular endothelial factor treatment, vitreous excision and membrane peeling surgery, <i>etc</i>. There is still a lack of safe and effective treatment methods, and it is therefore necessary to find new targets for diagnosis and treatment. With the development of molecular biology analysis technology, circular RNA(circRNA)has become one of the important research hotspots at present. It is reported that under the stimulation of various factors, the regulated expression of genes-circRNA regulates the development of DR by regulating the functions of retinal microvascular pericytes, retinal microvascular endothelial cells, and retinal pigment epithelial cells, which are involved in the pathological processes such as retinal basement membrane thickening, vascular leakage, apoptosis, inflammatory response and neovascularization. Therefore, this paper focuses on the research progress of cyclic RNA, competitive endogenous RNA and microRNA in the molecular mechanism of DR pathological alterations and therapeutic prospects, in order to provide some reference for clinical and basic research.