目的：观察奥密克戎感染致急性黄斑神经视网膜病变(AMN)的临床特征。方法：回顾性研究。纳入2022-12/2023-01在成都中医药大学附属医院确诊为AMN的患者9例18眼，均行频域光相干断层扫描(SD-OCT)检查、荧光素眼底血管造影(FFA)检查、眼底彩照、自发荧光(AF)、红外成像(IR)、光学相干断层扫描血管成像(OCTA)、炫彩检查等。随访1～3mo，观察预后情况。结果：奥密克戎感染致AMN的首发症状为眼部突发黄斑中心、旁中心暗点，伴或不伴视力下降、视物变形，且暗点症状可持续存在至少3mo。其影像特征性表现为SD-OCT检查可见视网膜外层结构中断、散在高反射病灶、视网膜外层萎缩，严重者内核层(INL)可见高反射病灶，或伴视网膜色素上皮层(RPE)下微囊腔； OCTA检查可见黄斑区深层毛细血管丛(DCP)血流密度降低； IR检查可见病灶区域表现为弱反射； 眼底彩照显示局限性棕褐色楔形病灶。结论：奥密克戎感染致AMN多见于青年女性，眼底病变主要为视网膜外层结构损伤，眼底病变程度可能与感染后全身炎症反应、眼部微循环障碍有关，多模式眼底影像学检查及奥密克戎感染病史有助于该病的诊断。

AIM: To observe the clinical features of acute macular neuroretinopathy(AMN)induced by Omicron.METHODS: A retrospective study. A total of 9 patients(18 eyes)diagnosed with AMN from December 2022 to January 2023 in the Hospital of Chengdu University of Traditional Chinese Medicine were included. Patients underwent spectral-domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), fundus photography, autofluorescence(AF), infrared reflectance(IR), optical coherence tomography angiography(OCTA)and multicolor, etc. Furthermore, they were followed up for 1～3mo and observed the prognosis.RESULTS: The initial symptom of the Omicron-induced AMN was the sudden onset of central/paracentral scotoma in the eyes with or without impaired vision and metamorphopsia, and the scotoma could persist for at least 3mo. The image features of AMN are as follows. First, the SD-OCT examination showed the rupture of outer retinal layers, scattered hyperreflective lesions, and atrophy of outer retinal layers. In severe cases, hyperreflective lesions were seen in the inner nuclear layer(INL)or with microcystic cavities under the retinal pigment epithelium(RPE). Second, the OCTA examination demonstrated the decreased blood flow density of the deep capillary plexus(DCP)of the macula. Third, the IR examination showed the weak reflection of lesion areas. Fourth, the fundus photography demonstrated the localized brown wedge-shaped lesion.CONCLUSIONS: The Omicron-induced AMN is mostly found in young females, and the characteristic manifestation of fundus is damage to the outer retinal layers. The extent of fundus lesions is related to the systemic inflammatory response and ocular microcirculatory changes after infection. The multimodal fundus image examination and a history of Omicron infection are helpful to diagnose the Omicron-induced AMN.

2022年度“杏林学者”学科人才科研提升计划(No.XKTD2022005)