{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T20:33:55Z","timestamp":1777581235932,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>In this case study, the authors describe peculiar bilateral cotton wool-like retinal lesions associated with macular edema in a patient with COVID-19 who was vaccinated with a single dose of AstraZeneca one month earlier. This patient had no pulmonary or systemic cardiovascular complications from COVID-19, as reported in other papers that found retinal lesions. However, the patient was diagnosed with idiopathic myopathy when discovering the SARS-CoV-2 infection. The patient was a 22-year-old white female with no previous history of morbidity, complaining of blurred vision in both eyes seven days after testing positive for SARS-CoV-2 by PCR (using nasal and oral swab) and confirmed through ELISA blood test (IgM positive). There was no ancillary test revealing diabetes mellitus. The patient presented with scattered whitish cotton wool-like lesions and a few hemorrhages on the posterior pole in fundus examination. On spectral domain optical coherence tomography (SD-OCT), there were hyperreflective lesions in the nerve fiber layer, ganglion cell layer, inner nuclear layer, and inner and outer plexiform layers at the site corresponding to the whitish cotton wool-like lesions in the posterior fundus photos. Moreover, the macula of both eyes had intraretinal and subretinal fluid, reversible with corticosteroid therapy. In conclusion, COVID-19 has been associated with capillary disorders at different target sites such as retina, lungs, and central nervous system. Similarly, vaccination against SARS-CoV-2 has been linked to retinal complications in the literature; however, cotton wool-like lesions have not yet been reported. There are many questions yet to be answered about the implications of COVID-19 infection and its vaccines.<\/jats:p>","DOI":"10.1177\/11206721221130393","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T01:48:08Z","timestamp":1665712088000},"page":"NP55-NP59","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Retinal microvascular abnormalities, cotton wool-like lesions, and macular edema following COVID-19 in a patient previously vaccinated with AstraZeneca and idiopathic myopathy"],"prefix":"10.1177","volume":"33","author":[{"given":"Nadyr A","family":"Damasceno","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Marcilio Dias Navy Hospital, Rio de Janeiro, RJ, Brazil"},{"name":"Department of Ophthalmology, Federal University of S\u00e3o Paulo, Paulista Medical School, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8147-802X","authenticated-orcid":false,"given":"Soraya","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Marcilio Dias Navy Hospital, Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Rezende","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Marcilio Dias Navy Hospital, Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas A","family":"Yannuzzi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel E","family":"Farah","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Federal University of S\u00e3o Paulo, Paulista Medical School, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Harry","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7881-3584","authenticated-orcid":false,"given":"Eduardo F","family":"Damasceno","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Federal Fluminense University, School of Medicine, Niteroi, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"bibr1-11206721221130393","first-page":"575","volume":"138","author":"Wu 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