Coxsackievirus-associated unilateral acute idiopathic maculopathy

A 25-year-old man presented with acute visual loss (20/400) following a Coxsackievirus prodrome approximately 1 month earlier. Multimodal imaging revealed a round, yellowish, placoid macular lesion with pinpoint hemorrhages, subretinal fluid (dots), and bacillary layer detachment (asterisk; Figure A,B). The patient was managed with clinical observation alone. After 21 days, visual acuity improved to 20/25, with resolution of the macular abnormalities (Figure C, D), consistent with the self-limiting nature of unilateral acute idiopathic maculopathy (UAIM)⁽¹⁾. Coxsackievirus infection has been implicated as a potential cause of this condition^(2,3).

REFERENCES

1. Yannuzzi LA, Jampol LM, Rabb MF, Sorenson JA, Beyrer C, Wilcox LM Jr. Unilateral acute idiopathic maculopathy. Arch Ophthalmol. 1991 Oct;109(10):1411-6.

2. Beck AP, Jampol LM, Glaser DA, Pollack JS. Is coxsackievirus the cause of unilateral acute idiopathic maculopathy? Arch Ophthalmol. 2004 Jan;122(1):121-3.

3. Milad D, Antaki F, Hammamji K. Unilateral acute idiopathic maculopathy in hand, foot, and mouth disease. Can J Ophthalmol. 2024 Apr;59(2):e176.

Submitted for publication: June 29, 2026.
Accepted for publication: August 12, 2026.

Data Availability Statement: The datasets generated and/or analyzed during the current study are already available.

Edited by

Editor-in-Chief: Newton Kara-Júnior

Associate Editor: Carlos Augusto Moreira Neto

Funding: This study received no specific financial support.

Disclosure of potential conflicts of interest: The authors declare no potential conflicts of interest.