Abstract： A 40-year-old man presented with 1 week of blurred vision in the left eye.The patient was previously diagnosed with neuromyelitis optica-associated optic neuritis in the left eye 3 months ago and had been treated with high-dose intravenous methylprednisolone in acute phase and low-dose corticosteroid therapy in chronic phase.One week ago,the patient was attacked by Covid-19 coronavirus,and then complained of vision loss in the left eye.The Ocular examination of the left eye showed that the best corrected visual acuity was FC/5cm,no specific abnormality was detected in the anterior segment except for a positive relative afferent pupillary defect.Fundus examination showed the edge of optic disc was clear,and the C/D ratio was 0.5.OCT indicated a detached retinal neuroepithelial layer(approximately 2PD)in the inferotemporal retina.Serum tests of infection and demyelination anti-bodies were negative,while MRI showed remarkable demyelination sign in the left optic nerve.The patient was diagnosed with 1.left recurrent serum-negative neuromyelitis optica-associated optic neuritis,and 2.bilateral central serous chorioretinopathy(CSC).High-dose intravenous methylprednisolone and sequential tapering was still administered for his optic neuritis,with follow-up suggested for CSC.After 6 months of treatment,the BCVA of the left eye was 0.6,and the CSC have resolved in both eyes.Summary:Neuromyelitis optica-related optic neuritis combined with foveal-spare CSC is rare and we still suggest to standardize the treatment of steroid and sequential tapering.