Abstract:

Objective To investigate the clinical and image features of acute macular neuroretinopathy (AMN). Design Retrospective case series. Participants Five eyes of 5 patients with AMN recruited from First Clinical Medical College Affiliated Hospital of Harbin Medical University from 2009 to 2015. Methods The clinical data and ocular examination results were collected for comprehensive analysis. Main Outcome Measures Clinical features, ocular fundus changes, spectral-domain optical coherence tomography (SD-OCT) images. Results 4 patients were young women, who had an acute onset of visual symptoms at presentation, including blurred vision and shadows. One patient had a preceding cold and fever. Fundoscopic examination revealed a round-shape, dark reddish-brown lesion at posterior area in 3 affected eyes, circular light orange pigmentary changes at the macula in 1 eye; a dark-red lobulated intraretinal subtle irregularities in inferior temporal macula in 1 eye. SD-OCT at presentation disclosed the focal loss of the ellipsoid zone and interdigitation zone in all affected eyes. Two patients showed a high reflective lesion in lateral outer nuclear layer. One patient showed a complete disruption of the ellipsoid zone and a focal disruption of the interdigitation zone, a hyperreflectivity in the outer side of the external limiting membrane and the outer nuclear layer was thinner. In one case with unknown onset time, SD-OCT exhibited the end of the disrupted external limiting membrane was connected to the RPE layer. The outer nuclear layer was thinned with the thickened inner and outer plexiform layers overlying. A focal depression in inner and outer plexiform layer and inner nuclear layer was found as well. Conclusion The 4 cases of AMN happened in young women. Fundus examination showed a dark-red lesion in macular area. SD-OCT revealed the focal loss of the ellipsoid zone and interdigitation zone with hyperreflectivity in photoreceptor layer in early stage. And late stage showed the loss and damage of the ellipsoid zone and interdigitation zone. (Ophthalmol CHN, 2016, 25: 391-395)

Key words: acute macular neuroretinopathy, optical coherence tomography