This 12YO boy presented with a few days of painless vision loss in his left eye. He had COVID one week earlier. There was no prior medical history. He was on no systemic medications. Vision was 20/30 in his normal right eye and 20/50 in his left eye.
Optos color RG imaging of his left eye shows a large macular serous detachment. Triton swept-source OCT confirms the serous detachment along with subretinal fibrin.
Fundus autofluorescence (FAF) shows faint peripapillary and macular hyper-FAF, and fluorescein angiography shows pooling beneath a nasal macular RPE detachment and larger areas of pooling within the multifocal serous detachments.
When he returned following 2 weeks of observation, the fluid and BALAD completely regressed with secondary drusen-like changes. Variable outer retinal atrophy is seen on OCT.
Learning Points:
Prior case reports of idiopathic central serous chorioretinopathy (ICSC) following COVID have been reported, although these have developed in patients who were also treated with systemic corticosteroids.
Fuganti et al reported 2 patients, both treated with systemic steroids, with post-COVID ICSC with BALAD (AJO Case Reports 2022;28;101690). We suspect our patient’s findings may have been COVID-related, given the atypical presentation and rapid resolution of the BALAD and serous fluid.
