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Case Rep Ophthalmol . Bilateral Retinal Ischemia in a Child with Influenza A: A Case Report

tetano

Editor, Senior Moderator
Case Rep Ophthalmol


. 2026 Jun 12;17(1):723-727.
doi: 10.1159/000552471. eCollection 2026 Jan-Dec.
Bilateral Retinal Ischemia in a Child with Influenza A: A Case Report

Andreas G Nilsson[SUP] 1 2 [/SUP], Elin Gunnlaugsdottir[SUP] 2 [/SUP], Hanna Maria Öhnell[SUP] 2 3 [/SUP]


Affiliations
Abstract

Introduction: Influenza A can cause extrapulmonary complications, including ocular manifestations. We present a rare case of extensive bilateral retinal ischemia in a pediatric patient following influenza A infection, involving acute macular neuroretinopathy (AMN), paracentral acute middle maculopathy (PAMM), and cotton-wool spots.
Case presentation: A 10-year-old boy presented with bilateral blurry vision 4 days after confirmed influenza A infection. Ophthalmologic evaluation revealed best-corrected visual acuity (BCVA) of 20/150 OD and 20/125 OS, with optical coherence tomography (OCT) demonstrating hyperreflective bands in the inner nuclear layer, outer plexiform layer, and outer nuclear layer, consistent with simultaneous AMN and PAMM. Cotton-wool spots were also present. The patient was treated with intravenous methylprednisolone, followed by oral prednisolone. BCVA improved to 20/20 in both eyes at 10 months, with complete resolution of OCT findings.
Conclusion: This case highlights the importance of early ophthalmologic assessment in children with visual symptoms following viral infections and suggests a potential role for corticosteroid treatment in severe post-viral retinal ischemia. Further studies are needed to clarify the efficacy of corticosteroids in such cases.

Keywords: Acute macular neuroretinopathy; Case report; Influenza A; Paediatric ophthalmology; Paracentral acute middle maculopathy.

 
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