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This cross-sectional study documented novel clinical and metabolomics findings in patients diagnosed with AMN associated with SARS-CoV-2 infection (AMN-SARS-CoV-2). The study was conducted at the Ophthalmology Department of the Second Affiliated Hospital of Chongqing Medical University between November 2022 and March 2023. The study was approved by the Institutional Ethics Committee of The Second Affiliated Hospital of Chongqing Medical University and adhered to relevant guidelines and regulations. Informed written consent was obtained from all patients.
Diagnosis of AMN-SARS-CoV-2 was based on the following clinical criteria: 1) Positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test; 2) acute onset paracentral or central scotoma history; 3) parafoveal grey dark wedge or teardrop-shaped lesions on near-infrared reflectance (NIR) imaging; 4) near-infrared parafoveal hypo-reflective lesions, hyper-reflectivity of the outer plexiform layer (OPL), and attenuation of ellipsoid and interdigitation zones on spectrum domain optical coherence tomography (SD-OCT) B-scans. The exclusion criteria included any other retinal diseases such as age-related macular degeneration or diabetic retinopathy. A total of 16 AMN-SARS-CoV-2 cases were identified, with 14 eventually enrolled. Control group samples were collected from age- and sex-matched SARS-CoV-2-positive patients without AMN (SARS-CoV-2-no AMN). All patients underwent comprehensive ophthalmological examinations, including best corrected visual acuity (BCVA), intraocular pressure, NIR, SD-OCT, OCT angiography (OCTA), and fundus photography. Peripheral blood was also collected from each individual for subsequent experiments.