SARS-Cov-2 Associated Paracentral Acute Middle Maculopathy: A Case Report with a Challenging Diagnosis

We present an intricate case of Paracentral acute middle maculopathy (PAMM) as part of the COVID-19 complex clinic presentation. 53 years old patient, pediatric nurse developed symptoms specific to SARS-Cov-2 infection (dry cough, headaches, myalgia’s and fever) which prompted her to get tested. 11 days into the disease, she experienced right eye mild loss of vision and received a short course of steroids for her concomitant pulmonary disease with no subjective improvement on vision. After 2 weeks of self-isolation, she had an ophthalmology examination and was misdiagnosed with optic neuritis. As her visual acuity was 6/6 she was monitored closely with perimetry and OCT. Patient showed reduction of central scotoma with no further treatment. One year later, an Angio-OCT was performed and upon reviewing the initial images, PAMM diagnosis was made.