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Shroff D, Kothari A, Gupta P, Sahni TK, Narain S. Hyperbaric Oxygen Therapy Combined with Immunosuppression for Acute Macular Neuroretinopathy in Systemic Lupus Erythematosus. Ocul Immunol Inflamm 2023; 31:355-361. [PMID: 35113760 DOI: 10.1080/09273948.2022.2029497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the use of hyperbaric oxygen therapy (HBOT) in conjunction with immunosuppression for acute macular neuroretinopathy (AMN) in systemic lupus erythematosus (SLE). METHODS Two known cases of SLE presented to us with blurred vision and paracentral scotomas due to AMN. Both cases reported worsening of their conditions despite the initiation of high-dose steroid therapy. HBOT was added on as a treatment modality to address vaso-occlusive ischemic injury. RESULTS Both patients underwent a total of twelve cycles of HBOT. Functional and anatomical improvements were noted immediately after the initiation of therapy and were maintained over more than one year of follow-up. No significant retinal thinning was noted on optical coherence tomography on disease resolution, as has been noted previously. Visual field scotoma showed a complete resolution. CONCLUSION Our cases suggest that HBOT may have a role in aiding functional and anatomical recovery in AMN associated with SLE.
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Affiliation(s)
- Daraius Shroff
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
| | - Abhishek Kothari
- Vitreoretinal Services, Pink City Eye & Retina Centre, Jaipur, India
| | - Priyanka Gupta
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
| | - Tarun Kumar Sahni
- Department of Internal and Hyperbaric Medicine, Indraprastha Apollo Hospital, New Delhi, India
| | - Shishir Narain
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
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2
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Cabral D, Ramtohul P, Zatreanu L, Galhoz D, Leitao M, Nogueira V, Sarraf D, Freund KB. Deep Capillary Plexus Features in Acute Macular Neuroretinopathy: Novel Insights Based on the Anatomy of Henle Fiber Layer. Invest Ophthalmol Vis Sci 2022; 63:4. [PMID: 36469026 PMCID: PMC9730735 DOI: 10.1167/iovs.63.13.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The purpose of this study was to identify a precise location of deep capillary plexus (DCP) injury in acute macular neuroretinopathy (AMN) lesions using multimodal imaging. METHODS En face structural optical coherence tomography (OCT) images were manually segmented to delineate outer retinal AMN lesions involving the ellipsoid zone and interdigitation zone. AMN lesion centroid was calculated, and image distortion was applied to correct for Henle fiber layer (HFL) length and orientation. The resulting image was registered with the corresponding en face OCT angiography (OCTA) image segmented at the DCP and structural OCT volume before grading for vascular and structural features, respectively. RESULTS Thirty-nine AMN lesions from 16 eyes (11 female patients, mean age 34 ± 4 years) were analyzed. After correcting for HFL anatomy, in 62% of AMN lesions, the centroid co-localized with a capillary vortex (pattern 1); flow defects were detected in 33% of lesions (pattern 2); and in 5% of lesions no specific pattern could be identified (pattern 3). The detection of a specific pattern increased after correcting the projection of AMN lesion for HFL anatomy (28% vs. 5%, P = 0.04). Outer nuclear layer thickness was lower in the centroid area in 10 (29%) AMN lesions from 6 patients, all corresponding to lesions fitting pattern 2 (r = 0.78, P < 0.001). CONCLUSIONS AMN lesions might be a result of DCP impairment at the level of the capillary vortex or draining venule. In eyes with AMN, the location of outer retinal changes associated with DCP ischemia appears to be influenced by the length and orientation of HFL.
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Affiliation(s)
- Diogo Cabral
- Vitreous Retina Macula Consultants of New York, New York, New York, United States,iNOVA4Health, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Prithvi Ramtohul
- Vitreous Retina Macula Consultants of New York, New York, New York, United States
| | - Luca Zatreanu
- Rochester Regional Health, Rochester, New York, United States
| | - Daniel Galhoz
- iNOVA4Health, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal,Instituto Superior Tecnico, Universidade de Lisboa, Lisbon, Portugal
| | - Miguel Leitao
- Instituto de Oftalmologia Dr. Gama Pinto, Lisbon, Portugal
| | - Vanda Nogueira
- Instituto de Oftalmologia Dr. Gama Pinto, Lisbon, Portugal
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, United States
| | - K. Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York, United States,Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York, United States
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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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Azar G, Bonnin S, Vasseur V, Faure C, Salviat F, Clermont CV, Titah C, Farès S, Boulanger E, Derrien S, Couturier A, Duvilliers A, Manassero A, Hage R, Tadayoni R, Behar-Cohen F, Mauget-Faÿsse M. Did the COVID-19 Pandemic Increase the Incidence of Acute Macular Neuroretinopathy? J Clin Med 2021; 10:jcm10215038. [PMID: 34768555 PMCID: PMC8585041 DOI: 10.3390/jcm10215038] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/23/2021] [Accepted: 10/27/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Acute macular neuroretinopathy (AMN) is an increasingly diagnosed disorder associated with several diseases. The aim of this study was to report the incidence of AMN cases diagnosed during the 2020 coronavirus disease 2019 (COVID-19) pandemic year in a French hospital, and to describe their different forms. Methods: All patients diagnosed between 2019 and 2020, in Paris Rothschild Foundation Hospital, with AMN, paracentral acute middle maculopathy (PAMM) and multiple evanescent white dot syndrome (MEWDS) were retrospectively collected using the software Ophtalmoquery® (Corilus, V1.86.0018, 9050 Gand, Belgium). Systemic and ophthalmological data from AMN patients were analyzed. Results: Eleven patients were diagnosed with AMN in 2020 vs. only one patient reported in 2019. The incidence of AMN significantly increased from 0.66/100,000 visits in 2019 to 8.97/100,000 visits in 2020 (p = 0.001), whereas the incidence of PAMM and MEWDS remained unchanged. Four (36%) of these AMN patients were tested for COVID-19 and received positive polymerase chain reaction (PCR) tests. Conclusions: The incidence of AMN cases increased significantly in our institution in 2020, which was the year of the COVID-19 pandemic. All AMN-tested patients received a positive COVID PCR test, suggesting a possible causative link. According to the different clinical presentations, AMN may reflect different severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pathogenic mechanisms.
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Affiliation(s)
- Georges Azar
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Anterior Segment Department, Adolphe de Rothschild Foundation, 75019 Paris, France
- Correspondence:
| | - Sophie Bonnin
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Vivien Vasseur
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Céline Faure
- Ramsay Générale de Santé, Private Hospital Saint Martin, 14000 Caen, France;
| | - Flore Salviat
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Catherine Vignal Clermont
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Cherif Titah
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Anterior Segment Department, Adolphe de Rothschild Foundation, 75019 Paris, France
| | - Selim Farès
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Anterior Segment Department, Adolphe de Rothschild Foundation, 75019 Paris, France
| | - Elise Boulanger
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Sabine Derrien
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Aude Couturier
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Ophthalmology Department, Lariboisière Hospital—Assistance Publique-Hôpitaux de Paris, AP-HP, 75010 Paris, France
| | - Amélie Duvilliers
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Anthony Manassero
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Rabih Hage
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Ramin Tadayoni
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Ophthalmology Department, Lariboisière Hospital—Assistance Publique-Hôpitaux de Paris, AP-HP, 75010 Paris, France
| | - Francine Behar-Cohen
- Ophthalmology Department, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, 75014 Paris, France;
- Centre de Recherche des Cordeliers, Team 17, INSERM U1138, Université de Paris, 75006 Paris, France
| | - Martine Mauget-Faÿsse
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
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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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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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Deschamps R, Vasseur V, Shor N, Vignal C, Salomon L, Gout O, Mauget‐Faÿsse M. A new association: acute macular neuroretinopathy in acute optic neuritis. Acta Ophthalmol 2019; 97:e753-e756. [PMID: 30761755 PMCID: PMC6798266 DOI: 10.1111/aos.14054] [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] [Received: 09/28/2018] [Accepted: 01/19/2019] [Indexed: 02/06/2023]
Abstract
Background Acute optic neuritis (AON) is a common optic nerve disease leading to retrograde degeneration of optic nerve axons, reflected by thinning of the inner retinal layers on optical coherence tomography. On the contrary, acute macular neuroretinopathy (AMN) type 2 is a rare outer retinal disorder that leads to thinning of the outer nuclear layers and is diagnosed by multimodal imaging. The aim of this study was to report a new association between these two diseases. Methods Patients with a first episode of optic neuritis were invited to participate in a study that involved optical coherence tomography evaluation at baseline and the following 1, 3, 6 and 12 months. All the study patients underwent ophthalmologic evaluation that comprised of visual acuity, visual field and multimodal imaging as well as orbital and brain Magnetic Resonance Imaging. A diagnosis of multiple sclerosis was made according to the 2010 McDonald criteria. Results Six of the 114 patients with acute optic neuritis also had acute macular neuroretinopathy, of whom three were positive for myelin oligodendrocyte glycoprotein antibodies (MOG‐Abs), two had relapsing–remitting multiple sclerosis and one had clinical isolated syndrome. Conclusion Our study suggests that it is imperative to check for associated AMN in cases of AON, especially those associated with MOG‐Abs.
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Affiliation(s)
- Romain Deschamps
- Department of Neurology Fondation Ophtalmologique Adolphe de Rothschild Paris France
| | - Vivien Vasseur
- Clinical Research Department Fondation Ophtalmologique Adolphe de Rothschild Paris France
| | - Natalia Shor
- Department of Radiology Fondation Ophtalmologique Adolphe de Rothschild Paris France
| | - Catherine Vignal
- Department of Neuro‐Ophthalmolology Fondation Ophtalmologique Adolphe de Rothschild Paris France
| | - Laurence Salomon
- Clinical Research Department Fondation Ophtalmologique Adolphe de Rothschild Paris France
| | - Olivier Gout
- Department of Neurology Fondation Ophtalmologique Adolphe de Rothschild Paris France
| | - Martine Mauget‐Faÿsse
- Clinical Research Department Fondation Ophtalmologique Adolphe de Rothschild Paris France
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8
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Wu JG, Huang ZY, Zhou WY. Paracentral Acute Middle Maculopathy Treated with Acupuncture: A Case Report. Chin J Integr Med 2019; 26:709-712. [PMID: 30972538 DOI: 10.1007/s11655-019-3155-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Jian-Guo Wu
- Department of Ophthalmology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Zi-Yang Huang
- Department of Ophthalmology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Wan-Yu Zhou
- Department of Ophthalmology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
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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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11
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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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12
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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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13
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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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14
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Acute macular neuroretinopathy misdiagnosed as optic neuritis. Int Ophthalmol 2014; 35:125-9. [DOI: 10.1007/s10792-014-0024-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 11/29/2014] [Indexed: 10/24/2022]
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15
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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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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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Sanjari N, Moein HR, Soheilian R, Soheilian M, Peyman GA. Enhanced Depth Imaging OCT and Indocyanine Green Angiography Changes in Acute Macular Neuroretinopathy. Ophthalmic Surg Lasers Imaging Retina 2013; 44:S36-9. [DOI: 10.3928/23258160-20131101-07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Accepted: 09/12/2013] [Indexed: 11/20/2022]
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