LiMiaoling , ZhangXiongze , JiYuying , YeBaikang , WenFeng
  • State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China;
WenFeng, Email: wenfeng208@foxmail.com
Macula lutea/injuries; Retinal diseases/diagnosis; Disease attributes
10.3760/cma.j.issn.1005-1015.2016.02.013
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Objective  To observe the clinical features of acute macular neuroretinopathy (AMN). Methods  Six patients (11 eyes) with AMN were included in this study, with every 2-week follow-ups till six months. Among them, five had preceding dengue fever (83.3%), one had history of head trauma (16.7%). All patients received routine examination, fundus photography, infrared reflectance (IR) imaging, spectral-domain optical coherence tomography (SD-OCT) scanning and fluorescein fundus angiography (FFA) initially, and fundus photography, IR, SD-OCT during follow-up. Results  Sudden onset of central/paracentral scotoma in one eye or both eyes was the main visual symptom. There were 1 eye with normal fundus, 2 eyes with wedge-shape lesions, 8 eyes with yellow-white or brown sheet lesion. IR imaging demonstrated localized areas of hypo-reflection in the macula. SD-OCT scanning through these areas revealed hyper-reflection in the photoreceptor layer and disruption of its normal reflective structures. Subsequent SD-OCT demonstrated that the hyper-reflection of the photoreceptor layer regressed gradually, followed by thinning of the outer nuclear layer. The external limiting membrane and ellipsoid zone became continuous; however, the interdigitation zone was not restored. There was no remarkable findings of the AMN lesions on FFA. The scotomas persisted in all 6 patients (11 eyes) by the last visit. Conclusions  IR imaging demonstrated localized areas of hypo-reflection in the macula. SD-OCT revealed hyper-reflection in the photoreceptor layer in acute stage and the interdigitation zone was not restored in late stage. AMN has a relative poor prognosis with persistent scotomas through at least 6 months.

Citation： LiMiaoling, ZhangXiongze, JiYuying, YeBaikang, WenFeng. Clinical features of acute macular neuroretinopathy. Chinese Journal of Ocular Fundus Diseases, 2016, 32(2): 169-171. doi: 10.3760/cma.j.issn.1005-1015.2016.02.013 Copy

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