Objective. Serous retinal detachment (SRD) is a common anatomical complication associated with dome-shaped macula (DSM) and staphyloma margin in myopic patients. Here we described the anatomical and functional outcomes obtained with the use of oral spironolactone, a mineralocorticoid antagonist, in the management of myopic patients with SRD associated with DSM and staphyloma margin. Methods. We evaluated both eyes of twelve myopic patients with long-standing SRD associated with DSM or staphyloma margin. The patients were treated daily for six months with oral spironolactone 50 mg. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT), determined by optical coherence tomography, were evaluated on the first day and on monthly follow-up visits. Results. Pretreatment BCVA (mean ± standard deviation) was 0.406 ± 0.324 LogMAR, and posttreatment BCVA was 0.421 ± 0.354 LogMAR (P = 0.489). Pretreatment CRT was 323.9 ± 78.6 μm, and after six months of treatment it was significantly lower, 291.2 ± 74.5 μm (P = 0.010). There were no treatment-related complications. Conclusions. We evaluated a novel treatment for SRD associated with DSM and staphyloma margin in myopic patients. After six months of treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced; however, there was no improvement in BCVA.

Purpose This study aims to describe the late retinal and optic nerve vascular complications due Coronavirus disease 2019 (COVID-19) in a Spanish young population. Methods We describe 15 eyes of 15 young patients without any other systemic risk factors, except controlled arterial hypertension in 5 of them, with the diagnosis of Central retinal vein occlusion (CRVO), Branch retinal vein occlusion (BRVO), Central retinal artery occlusion (CRAO), Branch retinal artery occlusion (BRAO), Mixed occlusions (Artery and Vein) and Non-arteritic ischemic optic neuropathy (NAION) with a previous COVID-19 infection demonstrated with a positive COVID-19 IgG Test (COVID-19 IgG/IgM Rapid Test Cassette, Lambra Laboratories, Madrid, Spain. Results 9 males and 6 females, with a mean age of presentation of 49.7 ± 9 years old were included. The mean time between infection and diagnosis of the disease was 3.5 ± 1.2 months. The most common retinal or optic nerve vascular complication was CRVO (6 cases), following by CRAO (4 cases), Mixed arterial and venous occlusions (2 cases), NAION (2 cases) and BRAO (1 case). Conclusions The presence of a retinal or optic nerve vascular event in a young patient without any other hypercoagulable or genetic thrombophilic disorder, should make us rule out a previous COVID-19 infection. Ophthalmologists must be awared that retinal circulation could be another potential site for thromboembolic and optic nerve circulatory insufficiency complications of COVID-19. To our knowledge, this is the longest case series of retinal or optic nerve vascular events described after COVID-19 infection.

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