The occurrence of age-related macular degeneration in the presence of a transferred, confirmed COVID-19

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Abstract

BACKGROUND: COVID-19 can affect the eyes and both the anterior and posterior segments of the eye. Retinal complications associated with COVID-19 have been reported.

CLINICAL CASE DESCRIPTION: We present a clinical case of age-related macular degeneration that developed during the acute period of coronavirus infection. A patient with COVID-19 and pneumonia (CT-1) experienced sudden decrease in visual acuity within 1 month. A dark spot appeared in front of the left eye, which did not disappear despite eye movements, and distortion of objects was observed. The disease was manifested acutely. A complete ophthalmological examination revealed a sharp decrease in visual acuity and a positive Amsler test (distortion of lines at a distance of 30 cm). In the field of view, scotomas were noted in the center. Ophthalmoscopy revealed light and dark foci in the central macular zone of the retina. Cptical coherence tomography with an angiographic mode detected severe changes at the level of the neuroepithelium and retinal pigment epithelium with the formation of gray tissue. Aflibercept (approved for use in the Russian Federation, No. LP-003544) was intravitreally prescribed according to the clinical guidelines for treating age-related macular degeneration. After treatment with positive dynamics, visual acuity increased to 1.0, and the thickness of the retina decreased by 102 microns.

CONCLUSION: The key objective in making a correct diagnosis was the use of optical coherence tomography with an angiographic mode. This method allows the visualization of the retinal layers without invasion The angiography mode allows the assessment of the state of the foveolar avascular zone and the density and perfusion of blood vessels, which enable the diagnosis of age-related macular degeneration and choroidal neovascularization. Timely antiangiogenic treatment, that is, a single intraocular injection, completely restored the visual acuity and visual field and normalized the state of the retina according to objective data of optical coherence tomography with angiography mode.

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About the authors

Mikhail A. Frolov

Peoples’ Friendship University of Russia named after Patrice Lumumba

Email: frolovma@rambler.ru
ORCID iD: 0000-0002-9833-6236
SPIN-code: 1697-6960

MD, Dr. Sci. (Med.), professor

Russian Federation, 6 Miklukho-Maklay street, 117198 Moscow

Ulyana S. Plyaskina

Peoples’ Friendship University of Russia named after Patrice Lumumba

Author for correspondence.
Email: plyaskina.ulyana@yandex.ru
ORCID iD: 0000-0002-9483-1571
SPIN-code: 3004-8545
Russian Federation, 6 Miklukho-Maklay street, 117198 Moscow

Irina V. Vorobyeva

Peoples’ Friendship University of Russia named after Patrice Lumumba; Russian Medical Academy of Continuous Professional Education

Email: irina.docent2000@mail.ru
ORCID iD: 0000-0003-2707-8417
SPIN-code: 1693-3019

MD, Dr. Sci. (Med.), professor

Russian Federation, 6 Miklukho-Maklay street, 117198 Moscow; Moscow

Alexander M. Frolov

Peoples’ Friendship University of Russia named after Patrice Lumumba

Email: frolov_sasha@mail.ru
ORCID iD: 0000-0003-0988-1361
SPIN-code: 6338-9946

MD, Cand. Sci. (Med.), associate professor

Russian Federation, 6 Miklukho-Maklay street, 117198 Moscow

Vladimir V. Biryukov

Peoples’ Friendship University of Russia named after Patrice Lumumba

Email: vladusmirgerb@gmail.com
ORCID iD: 0000-0002-4130-6511
SPIN-code: 4523-5303
Russian Federation, 6 Miklukho-Maklay street, 117198 Moscow

Sami Shallakh

Peoples’ Friendship University of Russia named after Patrice Lumumba

Email: samishallah@hotmail.com
ORCID iD: 0000-0003-3576-293X
SPIN-code: 5213-1262
Russian Federation, 6 Miklukho-Maklay street, 117198 Moscow

References

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  13. Belyaeva AI, Safronova MA, Stanishevskaya OM, et al. Postcovid ophthalmic manifwstations in the posterior segment of the eye. Modern Problems of Science and Education. 2023;(1):95. doi: 10.17513/spno.32391

Supplementary files

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2. Fig. 1. Ophthalmoscopic picture of the fundus; a — on the fundus photograph, drusen of the macular region (highlighted by a blue frame), b — the same drusen of the macular region on a large scale.

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3. Fig. 2. The result of computer perimetry.

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4. Fig. 3. Optical coherence tomography of the macular area after suffering COVID-19. Neuroepithelial detachment. Deformation of the pigment epithelium (highlighted by a red rectangle).

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5. Fig. 4. Macular optical coherence tomography in a month after anti-VEGF treatment. The fluid between the pigment and neuroepithelium has resolved. The deformation of the neuroepithelium remains (highlighted in red).

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