ABSTRACT
Purpose: We aim to highlight a case of COVID-19 associated acute macular neuroretinopathy (AMN), an outer retinopathy known to occur following febrile and flu-like illnesses. Method(s): Case report. Result(s): A 23-year-old Caucasian female presented with a 10-day history of sudden onset bilateral paracentral scotomata which developed following confirmed SARSCoV- 2 infection. The patient's medical history was significant for polycystic ovary syndrome and use of the combined oral contraceptive pill (OCP). Fundoscopic examination revealed multiple reddish-brown, wedge shaped lesions in both eyes perifoveally. Optical coherence tomography of these lesions demonstrated areas of ellipsoid zone disruption associated with overlying hyperreflectivity of outer retinal layers. The lesions were hyporeflective on infrared imaging. The location of lesions at the macula correlated nearly identically with Amsler grid recordings as illustrated by the patient. As a result, the patient was diagnosed with AMN. Other inflammatory, infective and hypercoaguable causes of outer retinopathy were excluded. While OCP use is a risk factor for AMN, the aetiology was determined to be associated with COVID-19, given the onset of visual symptoms closely following the onset of acute febrile illness. Conclusion(s): We report a rare case of AMN occurring in the context of recently diagnosed COVID-19, on the background of OCP use. More broadly, this case report aims to contribute to the broader literature regarding COVID- 19 associated ocular sequelae. Clinicians should consider asking about recent COVID-19 infection when encountering patients presenting with symptoms of AMN.
ABSTRACT
Purpose : 85% of US adults have a smartphone with 87 million people using a health or wellness app monthly in 20201. There are 350,000 eHealth apps2. Roughly 33M adults in the US have the chief complaint of vision loss. An estimated 93M are at high risk for serious visual impairment3 . Only half have visited an eye doctor in the past 12 months, due to COVID 193. American adults over the age of 18 fall into the demographic of mobile app users. Do free apps help our eye patients during this pandemic? Methods : We used the search terms “vision test” and “eye exam” in the Apple App Store to compile a list of the top 10 free apps. We looked for how many free apps have eye charts that are “recognized” such as Snellen chart, Landolt C, LogMAR chart, Amsler grid & Visual Field. Control: Inclusion criteria: 1) free;2) English language;3) ≥50 reviews, ≥4 star rating in the Apple App store. Exclusion criteria: 1) foreign languages 2) paid apps. Results : Results: Top 10 iOS apps (from most downloads to least) in the Apple App Store seen in Table 1. For all iOS apps, Snellen vision test: 9/10;Landolt C: 1/10;LogMAR chart: 3/10;Amsler grid: 3/10;Visual field 1/10. Only 1 app connected you with a local optometrist or ophthalmologist. Only 3/10 apps had >1K reviews. iOS apps do not provide a number of downloads. Conclusions : Although many adults have not received an eye exam over the past 12 months, physicians can still connect with their patients through public education with the use of mobile apps. However, current eHealth apps can improve their content for eye patients.