Acute macular neuroretinopathy following COVID-19 infection: Three case reports

Figure 2 Multimodal imaging and deep capillary plexus flow signal evolution in acute macular neuroretinopathy in Case 2. A and B: Ultrawide field pseudocolor fundus photography (Optos PLC, Dunfermline, Scotland, United Kingdom) shows scattered cotton-wool spots in both eyes; C and D. Near-infrared reflectance imaging shows hyporeflective lesions within the macular region; E and F. Optical coherence tomography (OCT) B-scans provide detailed visualization of hyperreflective foci within the outer plexiform layer and hyporeflective foci in the ellipsoid zone/interdigitation zone in both eyes, with additional hyperreflective foci observed in the inner nuclear layer of the right eye; G-I: Tracked OCT angiography (OCTA) (Plex Elite 9000; Carl Zeiss Meditec, Inc., Dublin, CA, United States), focused on the deep capillary plexus, reveals a gradual decrease in the flow signal (orange arrow) in the right eye in the follow-up period; J-L: Similar OCTA imaging of the deep capillary plexus for the left eye also shows progressive reduction in flow signal (orange arrow), underscoring the bilateral impact on vascular density over time.