Case series on 2 cases of macular damage caused by the novel coronavirus: A case report

Rationale: Macular damage is a rare yet significant ocular complication of coronavirus disease 2019 (COVID-19) infection. This report highlights the clinical features, diagnosis, treatment, and outcomes in 2 cases of COVID-19-associated macular damage, contributing to the understanding of its pathophysiology and management.

Patient concerns: Both patients presented with a sudden onset of visual impairment and black shadows in their central visual fields shortly after contracting COVID-19.

Diagnoses: The first patient, a 15-year-old male, was diagnosed with acute macular neuroretinopathy, evidenced by optical coherence tomography (OCT) imaging showing high-density shadows in the macular area. The second patient, a 28-year-old female, presented with more extensive macular lesions, confirmed via fundus photography and OCT imaging.

Interventions: Both patients received systemic corticosteroid therapy (oral prednisone acetate, 30 mg daily). The male patient was treated for 5 days, while the female patient underwent a 3-day treatment course.

Outcomes: The male patient showed significant improvement in visual acuity, with OCT imaging revealing the resolution of high-density shadows but persistent disruption of the ellipsoid zone. The female patient demonstrated partial improvement in visual symptoms, though residual macular abnormalities remained evident on imaging.

Lessons: COVID-19-associated macular damage appears to involve inflammatory and vascular mechanisms. Early systemic corticosteroid therapy may offer symptomatic relief and partially restore visual function. However, long-term monitoring is essential to address potential residual or progressive retinal damage.