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Pasol J, Ortega MR. Acute Macular Neuroretinopathy After COVID-19 Infection in a Patient With Multiple Sclerosis. J Neuroophthalmol 2024:00041327-990000000-00619. [PMID: 38589999 DOI: 10.1097/wno.0000000000002155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Joshua Pasol
- Clinical Ophthalmology (JP), Bascom Palmer Eye Institute University of Miami Miller School of Medicine, Plantation, Florida; and University of Miami Miller School of Medicine (MRO), Boca Raton, Florida
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2
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Icoz M, Gurturk-Icoz ŞG, Kolsuz-Koldamca H. Effect of oral contraceptive pills on the retinal microvascular structure: An optical coherence tomography angiography study. Photodiagnosis Photodyn Ther 2023:103635. [PMID: 37244452 DOI: 10.1016/j.pdpdt.2023.103635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND To investigate the effect of oral contraceptive pills (OCPs) on foveal avascular zone (FAZ), peripapillary capillary plexus, and superficial and deep capillary plexus (SCP and DCP) measurements. METHODS This cross-sectionally designed study included 32 healthy female participants using OCPs (3 mg drospirenone and 0.03 mg ethinylestradiol) for at least one year for contraception and 32 healthy controls that did not use any drugs. All subjects were evaluated using optical coherence tomography angiography (OCTA). Using OCTA, the measurements of SCP, DCP, radial peripapillary capillary (RPC) vessel density; FAZ area and perimeter; acircularity index (AI); and foveal density (FD) were undertaken. Each participant's measurements were taken while they were in the follicular phase of their menstrual cycles (day 3). RESULTS Age and body mass index did not significantly differ between the groups (p=0.56 and p=0.15, respectively). The DCP vessel densities in all the regions were lower in the OCP group (p<0.05 for all). The vessel densities of SCP and RPC, FAZ area and perimeter, AI, and FD were similar between the two groups (p>0.05 for all). CONCLUSION We determined that the DCP vessel density was reduced in women using this drug. OCPs can cause changes in retinal microvascular structures. Therefore, OCTA can be used in the follow-up of healthy women using OCP.
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Affiliation(s)
- Mehmet Icoz
- Department of Ophthalmology, Yozgat City Hospital, Yozgat, Turkey.
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3
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Kovalchuk B, Kessler LJ, Auffarth GU, Mayer CS. [Paracentral scotomas associated with COVID-19 infection]. DIE OPHTHALMOLOGIE 2023; 120:323-327. [PMID: 36085528 PMCID: PMC9462629 DOI: 10.1007/s00347-022-01726-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Bogdana Kovalchuk
- Univ.-Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Lucy J Kessler
- Univ.-Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Gerd U Auffarth
- Univ.-Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Christian S Mayer
- Univ.-Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
- Augenklinik am Ortenau Klinikum Offenburg-Kehl, Weingartenstr. 70, 77654, Offenburg, Deutschland
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The role of near-infrared reflectance imaging in retinal disease: A systematic review. Surv Ophthalmol 2022; 68:313-331. [PMID: 36535488 DOI: 10.1016/j.survophthal.2022.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Near-infrared reflectance (NIR) retinal imaging aids in a better visualization of structures at the level of outer retina, retinal pigment epithelium, and choroid. It has multiple advantages, including easy acquisition in association with structural spectral domain optical coherence tomography, more comfort for patients, and enhanced contrast and spatial resolution. It helps in the diagnosis of chorioretinal diseases that present with minimal funduscopic findings and can be used to follow up many chorioretinal conditions. We describe the chorioretinal NIR imaging appearance and the clinical role of NIR imaging in ocular inflammatory disease, vascular and acquired disease, degenerative disease, tumors, associated systemic condition, toxic and traumatic disease, optic nerve head conditions, and physiological findings.
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Sanjay S, Gadde SGK, Kumar Yadav N, Kawali A, Gupta A, Shetty R, Mahendradas P. "Bilateral Sequential Acute Macular Neuroretinopathy in an Asian Indian Female with β Thalassemia Trait following (Corona Virus Disease) COVID-19 Vaccination and Probable Recent COVID Infection- Multimodal Imaging Study.". Ocul Immunol Inflamm 2022; 30:1222-1227. [PMID: 35050826 DOI: 10.1080/09273948.2022.2026978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Corona virus disease (COVID-19) has been associated with a variety of ophthalmic manifestations including acute macular neuroretinopathy and paracentral middle maculopathy. Posterior segment manifestations after post COVID-19 vaccinations have been reported. CASE REPORT A 25- year-old Asian Indian female developed sequential bilateral AMN following a single dose of COVISHIELD™ vaccine. On investigations she was found to have a β thalassemia trait. Presentation started unilaterally and progressed to the other eye after a month. On clinical examination, the fundus was apparently normal in both eyes. Significant changes suggestive of AMN were seen on multimodal imaging of the posterior segment of the respective eye at the time of involvement which resolved spontaneously in due course. CONCLUSION We report a temporal association of COVID-19 vaccination and AMN.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | | | | | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Aditi Gupta
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Neuro-ophthalmology, Narayana Nethralaya, Bangalore, India
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6
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Sanjay S, Kawali A, Mahendradas P. Acute macular neuroretinopathy and COVID-19 vaccination. Indian J Ophthalmol 2021; 70:345-346. [PMID: 34937289 PMCID: PMC8917606 DOI: 10.4103/ijo.ijo_2542_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Padmamalini Mahendradas
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India
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7
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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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Mahjoub A, Ben Mrad S, Ben Abdesslem N, Haddar S, Mahjoub A, Ben Brahem M, Knani L, Ghorbel M, Mahjoub H. [Acute macular outer retinopathy: Contribution of optical coherence tomography-angiography (OCT-A)]. J Fr Ophtalmol 2020; 44:e19-e21. [PMID: 33190961 DOI: 10.1016/j.jfo.2020.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/19/2020] [Accepted: 04/22/2020] [Indexed: 10/23/2022]
Affiliation(s)
- A Mahjoub
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - S Ben Mrad
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie.
| | - N Ben Abdesslem
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - S Haddar
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - A Mahjoub
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - M Ben Brahem
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - L Knani
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - M Ghorbel
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - H Mahjoub
- Service d'ophtalmologie, CHU de Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
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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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Rauchegger T, Blatsios G, Haas G, Putz G, Zehetner C. C-Shaped Scotoma after Complicated Cesarean Section: A Case of Acute Macular Neuroretinopathy. Case Rep Ophthalmol 2020; 10:391-396. [PMID: 31911780 DOI: 10.1159/000504289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/20/2019] [Indexed: 11/19/2022] Open
Abstract
Acute macular neuroretinopathy (AMN) is a rare retinal disease that produces transient or permanent visual impairment and occurs predominantly in young, Caucasian women of childbearing age. It is often characterized by wedge-like macular lesions. Although the cause of AMN is unknown, recent research suggests a microvascular etiology. Various vascular pathologies, including post-viral illness, oral contraceptives, and use of vasoconstrictive agents, have been associated with AMN. We present a case of a woman with C-shaped visual field defects in both eyes after inadvertent exposure to intravenous high-dose epinephrine during onset of spinal anesthesia. At present, only 8 cases of AMN after exposure to epinephrine have been described in literature. To our knowledge, this is the first case of AMN that presented following epinephrine injection during childbirth.
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Affiliation(s)
- Teresa Rauchegger
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Georgios Blatsios
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Gertrud Haas
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Günther Putz
- Department of Anesthesiology and Intensive Care, Medical University Innsbruck, Innsbruck, Austria
| | - Claus Zehetner
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
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11
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Gupta N, Padidam S, Tewari A. Acute macular neuroretinopathy (AMN) related to energy drink consumption. BMJ Case Rep 2019; 12:12/12/e232144. [PMID: 31843776 DOI: 10.1136/bcr-2019-232144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This case identifies a newly found association between energy drinks and acute macular neuroretinopathy (AMN). Our patient, a 34-year-old woman with no significant ocular or previous medical history, presented with a 3-day history of decreased vision after consumption of multiple energy drinks. After near infrared and optical coherence tomography imaging, we were able to diagnose her with AMN. Our patient's vision improved over a 2-month course with no intervention. Our case aims to emphasise the effect of caffeine on the retina, as well as encourage clinicians to consider energy drinks as a causative agent of AMN.
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Affiliation(s)
- Neha Gupta
- Department of Ophthalmology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Sneha Padidam
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, USA
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12
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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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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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Bottin C, Grieve K, Rossant F, Pedinielli A, Mrejen S, Paques M. DIRECTIONAL VARIABILITY OF FUNDUS REFLECTANCE IN ACUTE MACULAR NEURORETINOPATHY: EVIDENCE FOR A CONTRIBUTION OF THE STILES-CRAWFORD EFFECT. Retin Cases Brief Rep 2018; 12 Suppl 1:S19-S24. [PMID: 29369084 DOI: 10.1097/icb.0000000000000701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE To document directional reflectivity of fundus lesions in a case of acute macular neuroretinopathy. METHODS Case report. Clinical and imaging data from a patient with acute macular neuroretinopathy were reviewed. Imaging comprised infrared scanning laser ophthalmoscopy, optical coherence tomography and flood-illumination adaptive optics images acquired through different entry pupils in the cardinal directions (approximately 2° eccentricity). RESULTS The patient reported acute bilateral paracentral scotoma revealing dark, wedge-shaped macular plaques which by optical coherence tomography were associated with focal loss of the visibility of the cone outer segment tip and inner/outer segment lines. Comparing scanning laser ophthalmoscopy images taken at different entry points in the pupil showed that macular plaques varied from hyporeflectance to isoreflectance. Cone counts by flood-illumination adaptive optics within plaques and optical coherence tomography features of the cone outer segment tip showed also a strong directional variability, peaking at near-normal values. Within each modality, fusion images showed that directional variability covered most of macular plaques. CONCLUSION The characteristic fundus abnormalities of acute macular neuroretinopathy may show a strong directional variability. Our findings suggest that the Stiles-Crawford effect may be an important factor in signs and symptoms of acute macular neuroretinopathy.
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Affiliation(s)
- Caroline Bottin
- Ophthalmology Department, Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS Clinical Investigation Center 1423, Paris, France
| | - Kate Grieve
- Ophthalmology Department, Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS Clinical Investigation Center 1423, Paris, France
- Université Pierre et Marie Curie-Paris 6, Paris, France
| | | | | | - Sarah Mrejen
- Ophthalmology Department, Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS Clinical Investigation Center 1423, Paris, France
| | - Michel Paques
- Ophthalmology Department, Quinze-Vingts Hospital, DHU SightMaintain, INSERM-DHOS Clinical Investigation Center 1423, Paris, France
- Université Pierre et Marie Curie-Paris 6, Paris, France
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Giuffrè C, Rabiolo A, Corbelli E, Carnevali A, Sacconi R, Querques L, Bandello F, Querques G. ACUTE MACULAR NEURORETINOPATHY AND PERIPHERAL RETINAL VASCULAR ABNORMALITIES IN A PATIENT BORN HIV SEROPOSITIVE. Retin Cases Brief Rep 2018; 12 Suppl 1:S118-S121. [PMID: 29016527 DOI: 10.1097/icb.0000000000000646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the case of a born HIV seropositive woman who developed outer retinal alterations secondary to vascular abnormalities in the perimacular region and in the periphery of both eyes. METHODS Case report. RESULTS A 21-year-old woman born HIV seropositive was referred for a routinary visit. Her best-corrected visual acuity was 20/20 in both eyes, and during the visit, only mild superotemporal metamorphopsia in the left eye was reported. Multimodal imaging disclosed findings consistent with acute macular neuroretinopathy such as reddish-brown lesions at fundus examination and disruption of ellipsoid zone at spectral domain optical coherence tomography. Peripheral vascular alterations were also noted at fluorescein angiography. CONCLUSION Several associations or risk factors have been identified in patients with acute macular neuroretinopathy, including oral contraceptives, epinephrine/ephedrine, or systemic shock. To the best of our knowledge, this is the first case describing peripheral vascular alterations and acute macular neuroretinopathy in association with HIV seropositivity at birth.
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Affiliation(s)
- Chiara Giuffrè
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alessandro Rabiolo
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Eleonora Corbelli
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Adriano Carnevali
- Department of Ophthalmology, University of "Magna Graecia," Catanzaro, Italy
| | - Riccardo Sacconi
- Department of Ophthalmology, University of Verona, University Hospital of Verona, Verona, Italy
| | - Lea Querques
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giuseppe Querques
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
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Shah P, Zaveri JS, Haddock LJ. Acute Macular Neuroretinopathy Following the Administration of an Influenza Vaccination. Ophthalmic Surg Lasers Imaging Retina 2018; 49:e165-e168. [DOI: 10.3928/23258160-20181002-23] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 03/26/2018] [Indexed: 02/07/2023]
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17
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Hernanz I, Horton S, Burke TR, Guly CM, Carreño E. Acute Macular Neuroretinopathy Phenotype in Behçet's Disease. Ophthalmic Surg Lasers Imaging Retina 2018; 49:634-638. [PMID: 30114310 DOI: 10.3928/23258160-20180803-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/28/2018] [Indexed: 12/12/2022]
Abstract
Acute macular neuroretinopathy (AMN) is a rare disease, the etiology of which remains unclear. An ischemic event at the level of the deep capillary plexus has been proposed. The authors present three cases of AMN in the context of active systemic Behçet's disease, with the support of multimodal imaging. All patients were known to have Behçet's disease before the diagnosis of AMN. AMN was confirmed in all three cases on spectral domain optical coherence tomography (SD-OCT), near infrared reflectance and OCT angiography. Behçet's disease is known to be a prothrombotic disease. The presentation of AMN in this context supports the presumed ischemic etiology of AMN. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:634-638.].
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Stanescu-Segall D, Yap C, Burton BJL. Acute Macular Neuroretinopathy following Oral Intake of Adrenergic Flu Treatments. Case Rep Ophthalmol 2018; 9:322-326. [PMID: 30022947 PMCID: PMC6047558 DOI: 10.1159/000487075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/22/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to report a case series of patients with acute macular neureretinopathy in which patients concomitantly used ephedrine or pseudo-ephedrine. Methods This is a retrospective case review. Results Two patients with retinal findings consistent with acute macular neuroretinopathy are presented. Conclusion Acute macular neuroretinopathy should be considered in any young patient with unexplained loss of vision and exposed to direct or indirect adrenergic stimulation.
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Affiliation(s)
| | - Chong Yap
- Epsom and St Helier NHS Trust, Epsom, United Kingdom
| | - Ben J L Burton
- James Paget University Hospital NHS Foundation Trust, Great Yarmouth, United Kingdom
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Wheatley HM, Sarraf D. ACUTE MACULAR NEURORETINOPATHY AFTER RANIBIZUMAB INJECTION IN A DIABETIC PATIENT. Retin Cases Brief Rep 2017; 11 Suppl 1:S148-S150. [PMID: 27556909 DOI: 10.1097/icb.0000000000000386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE To report a case of acute macular neuroretinopathy occurring after intravitreal ranibizumab injection for diabetic macular edema. METHODS Observational clinical case report. RESULTS The patient received an intravitreal ranibizumab (0.3 mg) injection for diabetic macular edema. Three days later, he had a decline in vision associated with a central and paracentral scotoma. Optical coherence tomography (OCT) demonstrated bandlike hyperreflectivity of the outer nuclear and plexiform layers corresponding to the patient's scotoma, consistent with the diagnosis of acute macular neuroretinopathy. There was spontaneous resolution of the abnormalities observed in optical coherence tomography, but only partial resolution of the scotoma was observed 4 months after presentation. CONCLUSION Diabetic retinopathy may be associated with acute macular neuroretinopathy. The temporal relationship between ranibizumab injection and the onset of acute macular neuroretinopathy in this case report raises the possibility of a causal relationship.
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Affiliation(s)
- H Matthew Wheatley
- *Department of Ophthalmology, Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey; †NJ Retina, New Brunswick, New Jersey; ‡Stein Eye Institute, UCLA, Los Angeles, California; and §Greater Los Angeles VA Healthcare Center, Los Angeles California
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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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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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Munk MR, Beck M, Kolb S, Larsen M, Hamann S, Valmaggia C, Zinkernagel MS. Quantification of retinal layer thickness changes in acute macular neuroretinopathy. Br J Ophthalmol 2016; 101:160-165. [PMID: 27170518 PMCID: PMC5293849 DOI: 10.1136/bjophthalmol-2016-308367] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/08/2016] [Accepted: 04/16/2016] [Indexed: 11/26/2022]
Abstract
Purpose To quantitatively evaluate retinal layer thickness changes in acute macular neuroretinopathy (AMN). Methods AMN areas were identified using near-infrared reflectance (NIR) images. Intraretinal layer segmentation using Heidelberg software was performed. The inbuilt ETDRS -grid was moved onto the AMN lesion and the mean retinal layer thicknesses of the central grid were recorded and compared with the corresponding area of the fellow eye at initial presentation and during follow-up. Results Eleven patients were included (mean age 26±6 years). AMN lesions at baseline had a significantly thinner outer nuclear layer (ONL) (51±21 µm vs 73±17 µm, p=0.002). The other layers, including inner nuclear layer (37±8 µm vs 38±6 µm, p=0.9) and outer plexiform layer (OPL) (45±19 µm vs 33±16 µm, p=0.1) did not show significant differences between the study eyes and fellow eyes. Adjacent to NIR image lesions, areas of OPL thickening were identified (study eye: 50±14 µm vs fellow eye: 39±16 µm, p=0.005) with corresponding thinning of ONL (study eye: 52±16 µm vs fellow eye: 69±16 µm, p=0.002). Conclusions AMN presents with characteristic quantitative retinal changes and the extent of the lesion may be more extensive than initially presumed from NIR image lesions.
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Affiliation(s)
- Marion R Munk
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Marco Beck
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Simone Kolb
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Michael Larsen
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Steffen Hamann
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
| | | | - Martin S Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Switzerland.,Department of Clinical Research, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Groat CL, Ellis BD, Leys MJ. A UNIQUE CASE OF ACUTE MACULAR NEURORETINOPATHY ASSOCIATED WITH COTTON WOOL SPOTS AND INTRARETINAL FLUID. Retin Cases Brief Rep 2016; 10:26-31. [PMID: 26035133 DOI: 10.1097/icb.0000000000000154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To discuss the clinical findings in a unique case of acute macular neuroretinopathy with a focus on the pathophysiology of this rare entity. METHODS The patient's clinical course was documented with color fundus photography and spectral domain ocular coherence tomography registered to infrared reflectance imaging. The visual field was assessed using the Amsler grid testing and Humphrey visual field 24-2. RESULTS Initial fundus photography showed cotton wool spots and slight darkening of the central macula in each eye. Optical coherence tomography showed initial hyperreflective plaques at the level of the outer plexiform layer/outer nuclear layer junction with subsequent thinning of the outer nuclear layer and corresponding disruption of the ellipsoid and outer segment/retinal pigment epithelium. Infrared reflectance imaging revealed perifoveal hyporeflective lesions in each eye with corresponding visual field defects on the Amsler grid and visual field testing. The hyporeflective infrared lesions became more discreet during the ensuing weeks and remained stable beyond 11 weeks. CONCLUSION The authors present the case of a 15-year-old girl diagnosed with acute macular neuroretinopathy. This case is notable in that she presented with cotton wool spots and intraretinal fluid, both of which are unusual for acute macular neuroretinopathy. The authors suggest that the presence of cotton wool spots and several small foci of intraretinal fluid seen in their patient may lend support to the ischemic hypothesis described by Sarraf et al. The optical coherence tomography images obtained in this case have the typical wedge-shaped or petaloid configuration, and the authors suggest that the shape of the lesions themselves also lends support to a vascular mechanism.
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Affiliation(s)
- Christopher L Groat
- Department of Ophthalmology, West Virginia University, Morgantown, West Virginia
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Munk MR, Jampol LM, Cunha Souza E, de Andrade GC, Esmaili DD, Sarraf D, Fawzi AA. New associations of classic acute macular neuroretinopathy. Br J Ophthalmol 2015; 100:389-94. [PMID: 26294104 DOI: 10.1136/bjophthalmol-2015-306845] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 07/17/2015] [Indexed: 12/17/2022]
Abstract
PURPOSE To describe novel underlying associations of classic acute macular neuroretinopathy (AMN). METHODS Multimodal imaging case series evaluating patients with classic AMN lesions and previously unreported underlying aetiologies. RESULTS Six patients were included (five women, one man, mean age 30±7 years). Mean distance best corrected visual acuity at initial presentation was 0.21±0.3 logMAR (mean Snellen acuity: 20/30, range 20/15-20/100) and at last follow-up visit 0.09±0.17 logMAR (Snellen acuity: 20/20, range 20/15-20/60). All cases but one had bilateral lesions and showed typical parafoveal hyporeflective lesions on infrared imaging, which corresponded to the hyper-reflectivity in the Henle's layer with attenuation of the external limiting membrane, the ellipsoid zone and interdigitation zone. Underlying diseases included thrombocytopenia and anaemia associated with dengue fever, acute lymphoblastic leukaemia, chronic kidney disease and ulcerative colitis, while Valsalva-like manoeuvre was found to be a potential trigger. Other novel associations included the use of lisdexamphetamine. CONCLUSIONS Classic AMN may be associated with leukaemia, dengue fever, ulcerative colitis and chronic kidney disease, probably as a result of chorioretinal hypoxia in the setting of thrombocytopenia and anaemia. Adrenergic agonists such as lisdexamphetamine may also contribute to the manifestation of AMN.
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Affiliation(s)
- Marion R Munk
- Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA Department of Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Lee M Jampol
- Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Gabriel Costa de Andrade
- Retina Clinic, São Paulo, Brazil Department of Ophthalmology, Federal University of São Paulo-UNIFESP/EPM, São Paulo, Brazil
| | - Daniel D Esmaili
- Retina-Vitreous Associates Medical Group, Los Angeles, California, USA
| | - David Sarraf
- Jules Stein Eye Institute, UCLA Greater LA VA Healthcare Center, Los Angeles, California, USA
| | - Amani A Fawzi
- Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
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