PURTSCHER-LIKE RETINOPATHY AND PARACENTRAL ACUTE MIDDLE MACULOPATHY CAUSED BY INDUSTRIAL SILICONE EMBOLISM.

PURPOSE: This article describes a rare occurrence of acute vision loss in a healthy young patient after a cosmetic procedure. METHODS: Findings on clinical examination, color fundus photography, and swept-source optical coherence tomography angiography. RESULTS: A previously healthy 26-year-old male-to-female transsexual presented with dyspnea, fever, and hypoxemia 1 day after cosmetic injection of industrial silicone for buttock augmentation. The patient reported decreased vision on the right eye 4 days later and decreased vision on the left eye 5 days later. Fundus examination revealed bilateral retinal precapillary occlusion, demonstrating intraretinal hemorrhages, cotton wool spots, and Purtscher flecks within the posterior pole of both eyes. Optical coherence tomography angiography revealed capillary ischemia and an enlarged foveal avascular zone. CONCLUSION: Swept-source optical coherence tomography is a valuable tool for evaluation of Purtscher-like retinopathy and paracentral acute middle maculopathy.

Ocular Assessments of a Series of Newborns Gestationally Exposed to Maternal COVID-19 Infection.

IMPORTANCE: Congenital viral infections leading to ocular abnormalities are frequent and devastating. As ophthalmological manifestations of COVID-19 in newborns are still unknown, it is important to clarify if SARS-CoV-2 could be associated with ocular abnormalities. OBJECTIVE: To determine whether exposure to SARS-CoV-2 is associated with outcomes in the eyes of newborns. DESIGN, SETTING, AND PARTICIPANTS: This case series enrolled newborns from April to November 2020 from 3 different maternity hospitals in São Paulo, Brazil. The diagnosis of COVID-19 in mothers and newborns was based on real-time reverse transcriptase-polymerase chain reaction assays with material obtained from oronasopharyngeal swab sample; positive IGM serology was also considered as a diagnostic test for mothers. Newborns were excluded if they had any evidence of another congenital infection. All infants underwent external ocular examination and binocular indirect ophthalmoscopy. EXPOSURES: Serology test for COVID-19 and detection of SARS-CoV-2 from oronasopharyngeal specimen using a real-time reverse transcriptase-polymerase chain reaction assay on both mothers and newborns. MAIN OUTCOMES AND MEASURES: Screening for ophthalmologic manifestation in newborns after maternal COVID-19 infection. RESULTS: A total of 165 newborns (age range at examination, 1 to 18 days) were evaluated. Of these, 123 (74.5%) were born at full term, and 42 (25.4%) were born preterm. Maternal gestational age at the time of COVID-19-positive test varied from first to 40th gestational weeks. Six newborns (3.6%) had positive polymerase chain reaction findings for SARS-CoV-2. One newborn tested positive within 18 days (horizontal transmission), and 5 newborns tested positive in the first day of life (possible vertical transmission). None had ocular abnormalities. Concerning exposed newborns with negative test results, 1 presented with venous engorgement and vascular tortuosity, 7 had intraretinal hemorrhages, and 2 were diagnosed as having retinopathy of prematurity. CONCLUSIONS AND RELEVANCE: In this uncontrolled case series of Brazilian newborns of mothers with COVID-19 infection, a low rate of COVID-19 infection was found among newborns, and none had ocular abnormalities. Additional controlled studies may be warranted to confirm these findings.