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Gabka K, Groselli S, Ulbig M. [Flickering scotoma after COVID vaccination : A further possible side effect of vaccination?]. Ophthalmologe 2021; 118:735-740. [PMID: 34152454 PMCID: PMC8215477 DOI: 10.1007/s00347-021-01435-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 11/25/2022]
Affiliation(s)
- K Gabka
- Klinik und Poliklinik für Augenheilkunde, Klinkum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
| | - S Groselli
- Klinik und Poliklinik für Augenheilkunde, Klinkum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - M Ulbig
- Klinik und Poliklinik für Augenheilkunde, Klinkum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
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2
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Ong SS, Ahmed I, Scott AW. Association of Acute Macular Neuroretinopathy or Paracentral Acute Middle Maculopathy with Sickle Cell Disease. ACTA ACUST UNITED AC 2021; 5:1146-1155. [DOI: 10.1016/j.oret.2021.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/31/2020] [Accepted: 01/11/2021] [Indexed: 12/11/2022]
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3
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Porta A, Tripodi S, Toro MD, Rejdak R, Rejdak K, Zanzottera EC, Ferentini F. Bilateral Acute Macular Neuroretinopathy in a Young Patient: Imaging and Visual Field during Two-Year-Follow-Up. Diagnostics (Basel) 2020; 10:diagnostics10050259. [PMID: 32354001 PMCID: PMC7278004 DOI: 10.3390/diagnostics10050259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/18/2020] [Accepted: 04/24/2020] [Indexed: 12/15/2022] Open
Abstract
Acute macular neuroretinopathy (AMN) is a rare disorder. We report a case of bilateral AMN in a young female patient, without any risk factors. She referred a positive scotoma in both eyes after flu-like symptoms. Fundus examination revealed parafoveal dark-reddish oval lesions in both eyes. Therefore, we performed visual field, optical coherence tomography (OCT), fluorescein angiography (FA) and indocyanine green angiography (ICG) at baseline and several times during the two years of follow-up. The infrared (IR) imaging showed one rounded hyporeflective lesion in the left eye and two similar lesions in the right eye. The OCT demonstrated the characteristic alterations in the outer retina. The visual field also demonstrated scotomas corresponding with these lesions. The OCT and IR features disappeared at the end of the follow-up except for the left eye, which continued to have hyperreflective spots in the outer plexiform layer. The patient complained about a residual scotoma only in the left eye after two years. Our case shows a difference in disease progression in the two eyes of the same patient, suggesting that several mechanisms can be implicated in the pathology of AMN.
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Affiliation(s)
- Alessandro Porta
- Department of Ophthalmology, Hospital C. Cantù, 20081 Abbiategrasso, Italy
| | - Sarah Tripodi
- Department of Ophthalmology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37024 Negrar, Italy
- Correspondence: ; Tel.: +39-3334441032
| | - Mario Damiano Toro
- Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland
- Faculty of Medical Science, Collegium Medicum Cardinal Stefan Wyszyński University, 01815 Warsaw, Poland
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, 20079 Lublin, Poland
| | | | - Fabio Ferentini
- Department of Ophthalmology, Hospital C. Cantù, 20081 Abbiategrasso, Italy
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4
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Optical coherence tomography diagnostic signs in posterior uveitis. Prog Retin Eye Res 2020; 75:100797. [DOI: 10.1016/j.preteyeres.2019.100797] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 08/31/2019] [Accepted: 09/05/2019] [Indexed: 12/22/2022]
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5
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En Face Optical Coherence Tomography Imaging Ellipsoid Zone Regeneration in Laser-Induced and Solar Maculopathies. Case Rep Ophthalmol Med 2019; 2019:3849871. [PMID: 31885977 PMCID: PMC6925683 DOI: 10.1155/2019/3849871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/15/2019] [Indexed: 11/17/2022] Open
Abstract
The purpose of the study was to analyze imaging findings in spectral domain en face optical coherence tomography (SD OCT) in patients with laser-induced and solar maculopathies focusing on the possible regeneration of the ellipsoid zone. In a retrospective case series of 3 patients (4 eyes) with solar maculopathy and 2 patients (3 eyes) with laser-induced maculopathy who underwent a comprehensive ocular examination, ellipsoid zone (EZ) was segmented from SD OCT data. Evaluation of EZ in en face OCT revealed a hyporeflective lesion surrounded by a hyperreflective border. The area of EZ alteration was measured manually in en face OCT. All patients showed partial EZ regeneration. Mean EZ alteration decreased from 0.12 mm2 (range: 0.05-0.32) at baseline to 0.07 mm2 (range: 0.01-0.22) at last follow-up (p = 0.018, mean follow-up: 372 days; range: 115-592). Mean best visual acuity (BVA) improved from 20/36 at baseline to 20/30 (p = 0.018). In conclusion, en face OCT imaging clearly delineated the area of EZ alteration in patients with laser-induced and solar maculopathies. Follow-up showed significant reformation of the EZ as well as improvement of BVA.
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Chen YC, Chen SN. Microvascular change in acute macular neuroretinopathy by using optical coherence tomography angiography. Taiwan J Ophthalmol 2019; 9:118-121. [PMID: 31198671 PMCID: PMC6557066 DOI: 10.4103/tjo.tjo_83_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A 27-year-old pregnant female underwent cesarean section due to preeclampsia. Two days after the delivery, she presented with acute onset of blurred vision in the left eye. Optical coherence tomography (OCT) revealed characteristic findings of acute macular neuroretinopathy (AMN) in both eyes. During the follow-up, her vision improved gradually, but outer nuclear layer thinning with disruption of ellipsoid zone was identified from OCT. OCT angiography was arranged and revealed both vascular defect in superficial and deep vascular plexus, which correlated with previous AMN lesions in both eyes. Subsequent microvascular change in AMN was found to involve both superficial and deep vascular plexus, which is different from the current consensus that AMN mainly involved deep vascular plexus. By using the OCT angiography, we can better visualize the detail retinal vascular structure and may identify the real mechanism in this rare retinal disorder.
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Affiliation(s)
- Yen-Chih Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan
| | - San-Ni Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan.,Department of Medicine, School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
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7
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Hoang A, Khine KT, Houghton OM. Recurrence of Acute Macular Neuroretinopathy. Ophthalmic Surg Lasers Imaging Retina 2018; 49:962-968. [PMID: 30566704 DOI: 10.3928/23258160-20181203-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/02/2018] [Indexed: 11/20/2022]
Abstract
A 31-year-old female with a 2-month history of a central scotoma was diagnosed with acute macular neuroretinopathy (AMNR). Her symptoms resolved spontaneously, only to recur 2 years later with progressively worsening visual field deficits that did not improve with a trial of oral prednisone. The authors report a case of AMNR that is distinguished from other reports by its recurrence in the same eye after complete resolution of the first episode. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:962-968.].
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Hufendiek K, Gamulescu MA, Hufendiek K, Helbig H, Märker D. Classification and characterization of acute macular neuroretinopathy with spectral domain optical coherence tomography. Int Ophthalmol 2017; 38:2403-2416. [PMID: 29030796 DOI: 10.1007/s10792-017-0742-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 10/05/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To classify and characterize AMN lesions with SD-OCT during a follow-up as long as 5 years. METHODS Retrospective study of 14 patients (18 eyes) with special focus on SD-OCT. We measured thickness of inner nuclear layer (INL), outer retinal layer (ONL), and hyperreflective band at baseline and during follow-up. AMN lesions were classified as type 1 and type 2. RESULTS Of 14 patients (six males, eight females, mean age 29.7 years), three patients (four eyes) had type 1 and nine (12 eyes) had type 2. Two patients did not meet the criteria for AMN type 1 or 2 and were therefore classified as new subtype of AMN. In all patients, statistically significant thinning of ONL and INL was observable. Mean ONL of all patients was 90.2 ± 7.81 and 72.3 ± 15.64 μm (p < 0.05) during follow-up; mean INL was 54.4 ± 10.71 and 37.5 ± 6.18 μm (p < 0.05) in the course. In the subgroup analysis in AMN type 2, the thinning of both ONL and INL was also statistically significant (mean ONL: 87.4 ± 6.02 and 71.6 ± 12.7 μm (p < 0.05); mean INL: 48.5 ± 5.04 and 38.5 ± 5.6 μm (p < 0.05)) in the course. CONCLUSION SD-OCT allows for classification, characterization, and further understanding of AMN lesions. Up to now, this is one of the largest AMN case series differentiating into different subtypes and following up for up to 5 years. Furthermore, we describe a new AMN subtype characterized by initially clinically visible yellowish parafoveal lesions, subtle pigmentary changes at late stage, lack of classic dark appearance on IR reflectance, involvement of RPE/Bruch's complex, and disruption of ellipsoid zone and interdigitation zone. The patients suffered from a prolonged visual impairment and paracentral scotomata. We propose the term AMN type 3 or "paracentral acute outer maculopathy."
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Affiliation(s)
- Katerina Hufendiek
- Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany.
- University Eye Hospital, Hannover Medical School, Hannover, Germany.
| | | | - Karsten Hufendiek
- Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany
- University Eye Hospital, Hannover Medical School, Hannover, Germany
| | - Horst Helbig
- Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany
| | - David Märker
- Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany
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Kim SJ, Park YM, Cho HK, Huh HD, Park JM. A Case of Acute Macular Neuroretinopathy in a Young Male. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.6.751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Su Jin Kim
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Young Min Park
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Hyun Kyung Cho
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Hyoun Do Huh
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jong Moon Park
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea
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Kumar V, Tewari R, Yadav D, Vikas SJ. Acute macular neuroretinopathy in a young hypertensive patient. Clin Exp Optom 2016; 100:288-290. [PMID: 27624580 DOI: 10.1111/cxo.12466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/08/2016] [Accepted: 06/10/2016] [Indexed: 11/26/2022] Open
Affiliation(s)
- Vinod Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ruchir Tewari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Dev Yadav
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - S J Vikas
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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11
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Bhavsar KV, Lin S, Rahimy E, Joseph A, Freund KB, Sarraf D, Cunningham ET. Acute macular neuroretinopathy: A comprehensive review of the literature. Surv Ophthalmol 2016; 61:538-65. [DOI: 10.1016/j.survophthal.2016.03.003] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 02/28/2016] [Accepted: 03/04/2016] [Indexed: 01/08/2023]
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12
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Chinskey ND, Rahimy E, Johnson MW. Acute Macular Neuroretinopathy Following Non-Ocular Trauma: A Hypothesis Regarding Pathophysiologic Mechanism. Ophthalmic Surg Lasers Imaging Retina 2016; 46:1013-20. [PMID: 26599243 DOI: 10.3928/23258160-20151027-05] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 09/10/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe the imaging characteristics and clinical course of acute macular neuroretinopathy (AMN) following non-ocular trauma, and to hypothesize a pathophysiologic mechanism for this syndrome. PATIENTS AND METHODS The records of five patients who developed symptoms and findings suggestive of AMN following trauma to the face or chest were retrospectively reviewed. Optical coherence tomography (OCT), infrared reflectance, fundus autofluorescence, fluorescein and indocyanine green angiography, and multifocal electroretinography were evaluated. RESULTS Visual symptoms started immediately or very soon after non-ocular trauma, and scotomas persisted at last follow-up (2 weeks to 10 years after trauma). OCT imaging performed within days of the trauma demonstrated focal areas of hyper-reflectivity in the outer plexiform and outer nuclear layers with eventual thinning of the outer nuclear layer, as well as variable loss of the ellipsoid and interdigitation zones. CONCLUSION Acute ischemic injury caused by trauma-induced hypotension and/or catecholamine release and involving the deep retinal capillary plexus is the pathogenic mechanism that most plausibly explains trauma-associated AMN.
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Audo I, Gocho K, Rossant F, Mohand-Saïd S, Loquin K, Bloch I, Sahel JA, Paques M. Functional and high-resolution retinal imaging monitoring photoreceptor damage in acute macular neuroretinopathy. Graefes Arch Clin Exp Ophthalmol 2015; 254:855-64. [PMID: 26344727 DOI: 10.1007/s00417-015-3136-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/30/2015] [Accepted: 08/10/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To report functional and high-resolution retinal imaging abnormalities, including adaptive optics (AO) throughout the course of acute macular neuroretinopathy (AMNR). METHODS Two female patients (four eyes) with a diagnosis of AMNR were observed at the Clinical Investigation Center, CHNO des Quinze-Vingts, Paris, France. The patients underwent detailed ophthalmic examination including best-corrected visual acuity, slit-lamp examination, kinetic and static perimetry, full-field and multifocal electroretinogram, infrared reflectance, autofluorescence imaging and spectral-domain optical coherence tomography (SD-OCT) and AO fundus imaging at presentation and during follow-up. RESULTS Both cases showed concomitant loss of integrity of the outer retinal structures on SD-OCT, and marked abnormalities on AO imaging with disruption of the visibility of the cone mosaic. In the first case, photoreceptor damage was seen to progress during several weeks before healing. In both cases, there were persistent morphological abnormalities of photoreceptors 1 year after onset. CONCLUSION This study further highlights the value of AO fundus imaging to facilitate detection, mapping, and monitoring of damage to the cone outer segments during AMNR. In particular, residual damage to the cone mosaic can be precisely documented.
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Affiliation(s)
- Isabelle Audo
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France. .,INSERM, U968, Paris, 75012, France. .,Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Paris, 75012, France. .,CNRS, UMR_7210, Paris, 75012, France. .,Département de Génétique, Curie/CHNO des Quinze-Vingts, Centre de Recherche Institut de la Vision, UMR S 968 Inserm / Université Pierre et Marie, 17, rue Moreau, 75012, Paris, France.
| | - Kiyoko Gocho
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.,Ophthalmology, Nippon Medical University, Chiba Hokusoh Hospital, Inzai, Japan
| | | | - Saddek Mohand-Saïd
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.,INSERM, U968, Paris, 75012, France.,Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Paris, 75012, France.,CNRS, UMR_7210, Paris, 75012, France
| | - Kevin Loquin
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | | | - José-Alain Sahel
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.,INSERM, U968, Paris, 75012, France.,Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Paris, 75012, France.,CNRS, UMR_7210, Paris, 75012, France.,Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.,Académie des Sciences-Institut de France, Paris, 75006, France
| | - Michel Paques
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.,INSERM, U968, Paris, 75012, France.,Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Paris, 75012, France.,CNRS, UMR_7210, Paris, 75012, France
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Mrejen S, Pang CE, Sarraf D, Goldberg NR, Gallego-Pinazo R, Klancnik JM, Sorenson JA, Yannuzzi LA, Freund KB. Adaptive optics imaging of cone mosaic abnormalities in acute macular neuroretinopathy. Ophthalmic Surg Lasers Imaging Retina 2015; 45:562-9. [PMID: 25423637 DOI: 10.3928/23258160-20141118-12] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/27/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To assess the cone photoreceptor mosaic in acute macular neuroretinopathy (AMN) using adaptive optics (AO) imaging. PATIENTS AND METHODS Four patients with AMN were evaluated retrospectively by near-infrared reflectance (IR) confocal scanning laser ophthalmoscopy (SLO), spectral-domain optical coherence tomography (SD-OCT), and a flood-illuminated retinal AO camera. Microperimetry was performed in one patient. RESULTS The cone photoreceptor density was decreased at the level of the AMN lesions. The cone mosaic disruption appeared heterogeneous and more widespread than the lesion detected in the IR-SLO and SD-OCT images. The areas of cone loss correlated with SD-OCT and microperimetry. After resolution of the AMN lesion on IR-SLO, there was incomplete recovery of the cone photoreceptor mosaic. CONCLUSION Cone photoreceptor damage and reconstitution were documented in vivo at the cellular level in AMN using AO imaging. AO imaging appeared more sensitive than combined IR-SLO and SD-OCT to detect and follow photoreceptor damage in patients with AMN.
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15
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Angiographic evidence of retinal artery transient occlusion in paracentral acute middle maculopathy. Retina 2015; 34:2158-60. [PMID: 24732698 DOI: 10.1097/iae.0000000000000140] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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[Multicolor imaging in a case of acute macular neuroretinopathy]. J Fr Ophtalmol 2015; 38:e19-21. [PMID: 25662916 DOI: 10.1016/j.jfo.2014.04.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 04/11/2014] [Accepted: 04/14/2014] [Indexed: 11/23/2022]
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17
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Aziz HA, Kheir WJ, Young RC, Isom RF, Dubovy SR. Acute Macular Neuroretinopathy: A Case Report and Review of the Literature, 2002–2012. Ophthalmic Surg Lasers Imaging Retina 2015; 46:114-24. [DOI: 10.3928/23258160-20150101-23] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 08/26/2013] [Indexed: 11/20/2022]
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Abstract
PURPOSE To evaluate the findings in a case of acute macular neuroretinopathy involving sudden development of scotomas accompanied by rapid focal increases in fundus autofluorescence. METHODS The clinical presentation of the patient was documented by color fundus photographs, fundus autofluorescence, infrared imaging, and high-resolution spectral domain optical coherence tomography. The scotomas were assessed by Humphrey visual field 10-2 and MP-1 microperimetry. RESULTS Visual field defects exhibited spatial correspondence with wedge-shaped lesions demonstrable in color fundus photographs and infrared imaging. It was notable that the lesions exhibited increased intensity on autofluorescence images obtained within 3 weeks of presentation. Optical coherence tomography revealed focal loss of photoreceptor inner segment/outer segment junctions in both eyes. CONCLUSION This case was distinguished by the relative rapidity with which the lesions became hyperautofluorescent in fundus autofluorescence images. Given that the bisretinoids that are the source of autofluorescence form in photoreceptor cells and are transferred to retinal pigment epithelium secondarily, the rapid increase in autofluorescence is unlikely to only reflect retinal pigment epithelium status and is more likely to be indicative of photoreceptor cell dysfunctioning and loss of structural integrity.
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Tolou C, Mahieu L, Salmon L, Hamid S, Suarez C, Garcia D, Pagot-Mathis V, Gomane C, Berot A, Malecaze F, Soler V. [Multimodal imaging in the diagnosis of acute macular neuroretinopathy]. J Fr Ophtalmol 2014; 37:796-803. [PMID: 25313090 DOI: 10.1016/j.jfo.2014.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 04/23/2014] [Accepted: 04/25/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Acute macular neuroretinopathy is a retinal disease, usually presenting with a "normal fundus". Thus, this condition can be mistaken for optic neuropathy. Herein we present five clinical cases of patients affected with acute macular neuroretinopathy; one of them is a retrospective diagnosis while the others were diagnosed on initial examination. In the five cases, multimodal imaging with infrared photography and OCT helped to establish the diagnosis. MATERIAL AND METHODS Retrospective study of five clinical cases. Initial and final best visual acuities as well as infrared and OCT imaging were collected for all patients. RESULTS All patients initially reported a visual disturbance associated with a more or less severe decrease in visual acuity. Infrared imaging showed a dark, perifoveolar appearance of the lesions. In all cases, OCT images showed thickening and hyperreflectivity of the outer plexiform layer, extending towards the outer retinal layers. CONCLUSION Acute macular neuroretinopathy is a clinical entity that has been long-described, which now benefits widely from new imaging technologies, allowing an earlier and more accurate diagnosis, but calling into question the actual name of this condition. The exact pathophysiology of the condition remains nonetheless incompletely elucidated.
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Affiliation(s)
- C Tolou
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France; Laboratoire GR2DE, Inserm UMRS1043, centre de physiopathologie de Toulouse Purpan, place Baylac, 31059 Toulouse, France
| | - L Mahieu
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France
| | - L Salmon
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France
| | - S Hamid
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France
| | - C Suarez
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France
| | - D Garcia
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France
| | - V Pagot-Mathis
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France
| | - C Gomane
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France
| | - A Berot
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France
| | - F Malecaze
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France; Laboratoire GR2DE, Inserm UMRS1043, centre de physiopathologie de Toulouse Purpan, place Baylac, 31059 Toulouse, France
| | - V Soler
- Centre de la rétine, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne TSA 70034, 31059 Toulouse cedex 9, France; Laboratoire GR2DE, Inserm UMRS1043, centre de physiopathologie de Toulouse Purpan, place Baylac, 31059 Toulouse, France.
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Hansen SO, Cooper RF, Dubra A, Carroll J, Weinberg DV. Selective cone photoreceptor injury in acute macular neuroretinopathy. Retina 2014; 33:1650-8. [PMID: 23615345 DOI: 10.1097/iae.0b013e31828cd03a] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate retinal structural and functional abnormalities in a patient with acute macular neuroretinopathy. METHODS An adaptive optics scanning light ophthalmoscope was used to image the photoreceptor mosaic and assess rod and cone structure. Spectral-domain optical coherence tomography was used to examine retinal lamination. Microperimetry was used to assess function across the macula. RESULTS Microperimetry showed reduced function of localized areas within retinal lesions corresponding to subjective scotomas. Spectral-domain optical coherence tomography imaging revealed attenuation of two outer retinal bands typically thought to reflect photoreceptor structure. Adaptive optics scanning light ophthalmoscope images of the photoreceptor mosaic revealed a heterogeneous presentation within these lesions. There were areas containing non-waveguiding cones and other areas of decreased cone density where the remaining rods had expanded to fill in the vacant space. Within these lesions, cone densities were shown to be significantly lower than eccentricity-matched areas of normal retina, as well as accepted histologic measurements. A 6-month follow-up revealed no change in rod or cone structure. CONCLUSION Imaging of acute macular neuroretinopathy using an adaptive optics scanning light ophthalmoscope shows a preferential disruption of cone photoreceptor structure within the region of decreased retinal sensitivity (as measured by microperimetry). Adaptive optics-based imaging tools provide a noninvasive way to assess photoreceptor structure at a level of detail that is not resolved by use of conventional spectral-domain optical coherence tomography or other clinical measures.
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Affiliation(s)
- Sean O Hansen
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI, USA
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Makino S, Tampo H. Acute macular neuroretinopathy in a 15-year-old boy: optical coherence tomography and visual acuity findings. Case Rep Ophthalmol 2014; 5:11-5. [PMID: 24575033 PMCID: PMC3934695 DOI: 10.1159/000358166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To report a case of acute macular neuroretinopathy (AMN) in a 15-year-old boy. METHODS Images were obtained with fundus photography and optical coherence tomography (OCT). RESULTS The patient complained of blurred vision and a small central scotoma in the left eye. Left visual acuity was 0.3. Fundus photographs revealed a small dark area in the fovea of the left eye. OCT showed attenuation of the photoreceptor inner segment (IS)/outer segment (OS) line and the OS/retinal pigment epithelium (RPE) line in the left eye. One week after the initial visit, left visual acuity had improved to 0.6, and there was partial recovery of the IS/OS line with focal thinning of the OS/RPE line. One month later, left visual acuity had improved to 0.8, and OCT showed complete restoration of the IS/OS line and the OS/RPE line. CONCLUSIONS To our knowledge, this is the youngest patient reported with a diagnosis of AMN. Changes in microstructural findings and visual acuity were analogous during recovery of AMN in our patient.
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Affiliation(s)
- Shinji Makino
- Department of Ophthalmology, Jichi Medical University, Shimotsuke, Japan
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22
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Nentwich MM, Leys A, Cramer A, Ulbig MW. Traumatic retinopathy presenting as acute macular neuroretinopathy. Br J Ophthalmol 2013; 97:1268-72. [PMID: 23853167 DOI: 10.1136/bjophthalmol-2013-303354] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM Traumatic retinopathy presenting as acute macular neuroretinopathy (AMNR) is an uncommon disease causing paracentral scotomas after indirect trauma. METHODS We report on five patients (six eyes) with AMNR with a temporary reduction of visual acuity and persistent paracentral scotomas after indirect trauma. The findings were documented using multimodal imaging and the follow-up was up to 32 months. RESULTS Initially, fundoscopy was unremarkable in all patients while visual acuity (Snellen equivalents) varied between 0.03 and 1.0, and a paracentral scotoma was present in all patients. During follow-up, visual acuity recovered to 1.0 in all patients while the paracentral scotomas persisted. Spectral-domain optical coherence tomography revealed a disruption of the inner/outer segment junction within the macular lesion and changes in the outer nuclear layer, which slowly recovered partly during the follow-up. CONCLUSIONS These findings suggest that indirect trauma can cause changes in the outer retina resembling those seen in AMNR, resulting in persisting paracentral scotomas.
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Affiliation(s)
- Martin M Nentwich
- Department of Ophthalmology, Ludwig-Maximilians-University, , Munich, Germany
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Onal S, Tugal-Tutkun I, Neri P, P Herbort C. Optical coherence tomography imaging in uveitis. Int Ophthalmol 2013; 34:401-35. [DOI: 10.1007/s10792-013-9822-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 06/24/2013] [Indexed: 11/28/2022]
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ACUTE MACULAR NEURORETINOPATHY ASSOCIATED WITH THE USE OF NOREPINEPHRINE REUPTAKE INHIBITORS. Retin Cases Brief Rep 2013; 7:146-9. [PMID: 25390808 DOI: 10.1097/icb.0b013e318274a74c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Spectral domain optical coherence tomography evolutive features in acute macular neuroretinopathy. Eur J Ophthalmol 2012; 22:850-2. [PMID: 22610717 DOI: 10.5301/ejo.5000172] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2012] [Indexed: 11/20/2022]
Abstract
PURPOSE To demonstrate the usefulness of spectral domain optical coherence tomography (SD-OCT) in investigating the evolution of the retinal outer lesions seen in acute macular neuroretinopathy (AMN). METHODS A 32-year-old woman presented with a 1-day history of paracentral dark spot in the left eye, preceded by a flulike illness. A full ophthalmologic examination, color vision, visual field examination, and conventional imaging of the retina were done. Scanning laser ophthalmoscopic infrared imaging and SD-OCT of the macular region were performed. RESULTS Best-corrected visual acuity was 20/20 in both eyes. Slit-lamp examination as well as retinal photographs were unrevealing. Scanning laser ophthalmoscopic infrared examination showed a dark, sharp, oval area in the macular region that corresponded to a rounded patch drawn by the patient on an Amsler grid. The SD-OCT showed focal highly reflective lesion of outer plexiform layer (OPL) extending to the outer nuclear layer. After recovery of the OPL, follow-up SD-OCT showed an associated disruption of the external limiting membrane and the retinal pigment epithelium inner band as well as thinning of the inner segment/outer segment junction. Retinal inner layers were otherwise normal. CONCLUSIONS Spectral domain optical coherence tomography is of particular interest in the diagnosis of AMN. It is also very useful in featuring the chronological events happening in the outer retina. As the lesions shown are confined to the outer layers, this condition should be called acute macular outer retinopathy rather than AMN.
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Early Spectral-Domain Optical Coherence Tomography Findings in Acute Macular Neuroretinopathy. Retina 2012; 32:409-10. [PMID: 22277907 DOI: 10.1097/iae.0b013e31822f573a] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Yzer S, Freund KB, Engelbert M. Imaging in the diagnosis and management of acute macular neuroretinopathy. Int Ophthalmol Clin 2012; 52:269-273. [PMID: 22954950 DOI: 10.1097/iio.0b013e31826704a4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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[Acute macular neuroretinopathy]. Ophthalmologe 2011; 108:1168-70. [PMID: 21947577 DOI: 10.1007/s00347-011-2421-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A 24-year-old female patient presented with sudden onset of paracentral visual field defects of the right eye, which were noticed 2 months before the clinical examination. The slit lamp examination of the anterior and posterior segments showed unremarkable findings but three oval, well demarcated, hyporeflective areas were noticed in the right posterior pole in infrared fundus photographs. A similar small area was found in the left posterior pole. Optical coherence tomography (Cirrus OCT) showed a structural defect of the hyperreflective bands of the outer retina. The diagnosis of acute macular neuroretinopathy was made.
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A Unique Case of Autoimmune Retinopathy Associated with Anti-Alpha-Enolase Antibodies. Case Rep Ophthalmol Med 2011; 2011:371324. [PMID: 22606458 PMCID: PMC3350057 DOI: 10.1155/2011/371324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 11/30/2011] [Indexed: 11/23/2022] Open
Abstract
Background. We report a case of autoimmune retinopathy associated with anti-alpha-enolase antibodies with unique manifestations. Methods. A case report. Results. A 30-year-old male experienced recurrent, primarily peripheral visual field disturbances and minimal photopsia, with interval symptom resolution. Fundus changes subsequently developed in areas corresponding to the previous visual field symptoms. Electroretinogram showed bilaterally symmetric abnormalities of light-adapted responses and suggested loss of photoreceptor function. Only anti-alpha-enolase antibodies were detected on Western blot. Our patient noted cutaneous symptoms at the time of both episodes of visual symptoms, but not in the interim. Biomicroscopy revealed subtle small reddish spots in areas of the peripheral retina corresponding to the areas of the patient's visual field where he noted symptoms. To our knowledge these reddish spots have not been reported in autoimmune retinopathy and may clinically support in vitro and in vivo evidence that anti-alpha-enolase antibodies may target photoreceptors. Conclusions. Our patient demonstrates some unique features adding to the known characteristics of autoimmune retinopathy associated with anti-alpha-enolase antibodies. As more cases are reported, further understanding of the features and pathophysiology of this rare condition will hopefully be elucidated.
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