Diagnosis Of Acute Macular Neuroretinopathy Research Articles

Acute Macular Neuroretinopathy Following Moderna mRNA COVID-19 Vaccination

Purpose: We report a case of acute macular neuroretinopathy (AMN) following and then exacerbated by mRNA COVID-19 booster vaccination. Methods: Report of a case Observations: A 79-year-old Caucasian male presented with a central scotoma in the right eye 2 weeks following administration of his second mRNA COVID-19 vaccination. Optical coherence tomography, fundus autofluorescence and color photography, fluorescein, ICG, and clinical findings were consistent with a diagnosis of AMN. Anatomy and symptoms worsened 8 months later, approximately 2 weeks after the third mRNA COVID-19 vaccine. Improvement in symptoms and findings occurred without therapy 15 months post-presentation. Discussion: This post-COVID vaccine AMN case is reported following an mRNA vaccine. The chronological relationship to both vaccines, exacerbation after the third vaccine, and occurrence in an older male without the recognized risk factors for non-vaccine-related AMN are compelling for possible causality. Depending on the patient’s health and the state of the COVID pandemic with regard to public health, should AMN occur soon after COVID vaccination, clinicians may consider foregoing additional vaccination/boosters or switching to an alternate COVID vaccine vector.

Neurorétinopathie maculaire aiguë : description et intérêt de l’OCT en face, série de cas

Acute macular neuroretinopathy (AMN) is a rare disease characterized by involvement of the outer retinal layers of the macula. The diagnosis of AMN is based on multimodal imaging, combining infrared reflectance (IR) imaging and optical coherence tomography with B-scan analysis (OCT-B). The en face OCT is a tomographic image processing technique, integrating data from entire A-scans to create a frontal retinal image of the desired area. Structural en face OCT imaging appears to be effective in delineating AMN lesions, using segmentation between the outer plexiform line and the ellipsoid line. In the future, analysis of the various modalities of a single OCT acquisition may be sufficient to diagnose AMN.

Differentiation between acute macular neuroretinopathy and paracentral acute middle maculopathy in elderly persons: two case reports

BackgroundWe report one case of rare acute macular neuroretinopathy (AMN) in an elderly patient with hypertension and one case of common paracentral acute middle maculopathy (PAMM) in a patient with diabetes mellitus to illustrate the difference between the two diseases.Case presentationThis report describes two cases, one involving AMN and the other PAMM. The first patient was a 70-year-old man complaining of blurred vision for 3 days. He was examined with fundus photography, optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT); a diagnosis of AMN was established. The second patient was a 50-year-old woman who complained of decreased vision during the past month. She had had diabetes mellitus for 6 years. From the ophthalmic imaging examination, the patient was diagnosed with PAMM and non-proliferative diabetic retinopathy (NPDR). Both patients were treated with drugs for improving microcirculation and neurotrophic drugs; however, there was no significant improvement in visual acuity.ConclusionsAMN is more common in young patients and is rarely observed in elderly patients with systemic diseases. The OCTA examination has an auxiliary diagnostic value for deep retinal capillary network ischaemia. Meanwhile, OCT examination has important imaging value in differentiating AMN from PAMM and can help avoid missed diagnoses.

Choroidal Features of Acute Macular Neuroretinopathy via Optical Coherence Tomography Angiography and Correlation With Serial Multimodal Imaging

Acute macular neuroretinopathy (AMN) is a rare, idiopathic condition resembling other acute maculopathies such as paracentral acute middle maculopathy. The pathophysiology of AMN is not well understood, and the role of the choroid in the pathogenesis of AMN remains controversial. To describe initial and serial multimodal imaging findings in AMN, with attention to choroidal vascular changes. Retrospective case series at a single institution, tertiary referral center. The case series included 7 patients with clinical diagnosis of AMN. Multimodal imaging findings, including fundus photography, fluorescein angiography, spectral-domain optical coherence tomography (OCT), en face near-infrared imaging, fundus autofluorescence, optical coherence tomography angiography (OCTA), and automated quantification of the regional structural context of choroidal flow interest between different imaging modalities, using an automatic algorithm. Nine eyes from 7 patients (5 women and 2 men; mean age, 40.1 years) with a diagnosis of AMN were included. Mean duration of follow-up was 11 weeks (range, 1-25 weeks). All eyes had inner choroidal flow void on OCTA that topographically corresponded to regions of abnormal hyperreflectance of the outer retinal layers on spectral-domain OCT and hyporeflectance on en face near-infrared imaging (dice similarity coefficient, 0.76). For each patient, these areas of choroidal flow void on OCTA persisted during the follow-up period, while the abnormal hyperreflectance of outer plexiform layer and inner nuclear layer on spectral-domain OCT was observed to improve. These findings suggest that areas of inner choroidal vascular flow void on OCTA are seen in patients with AMN. These areas may persist weeks after the onset of symptoms and suggest that vascular compromise of the inner choroid may be involved in the pathogenesis of AMN.

We cannot see what she cannot ignore

A 32-year-old woman presented with the acute onset of a small scotoma in the right visual field. She was initially thought to have optic neuritis, but brain magnetic resonance imaging was normal. A review of her symptoms and medications disclosed recent use of oral contraceptives. Near-infrared imaging was the only objective abnormality, consistent with her Amsler grid changes, leading to the diagnosis of acute macular neuroretinopathy.

Acute Macular Neuroretinopathy Presenting as Bitemporal Defects on Humphrey Visual Field

A 25-year-old woman presented with blurry vision, headache, nausea, and syncope. Humphrey visual field testing revealed bitemporal defects, but magnetic resonance imaging was negative for chiasmal pathology. Macular optical coherence tomography showed focal parafoveal disruption of the photoreceptor inner segment/outer segment junction and infrared imaging showed hyporeflective macular lesions in both eyes. Our case demonstrates a diagnosis of acute macular neuroretinopathy that presented with bitemporal visual field defects. To our knowledge, bitemporal visual field loss, mimicking chiasmal pathology, has not been reported previously in association with acute macular neuroretinopathy.

Spectral domain optical coherence tomography evolutive features in acute macular neuroretinopathy

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). 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. 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. 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.

Teenage Acute Macular Neuroretinopathy

To present the first case of acute macular neuroretinopathy in a teenager. Case report, optical coherence tomography, fluorescein angiography, electroretinography. Optical coherence tomography, fluorescein angiography, and electroretinography were used to diagnose acute macular neuroretinopathy. Laboratory results were positive for HLA-B7. The rare diagnosis of acute macular neuroretinopathy should be considered in girls on oral contraceptives, with a recent history of acute viral illness, who present with acute rapid onset of multiple, paracentral scotomas.

Longitudinal findings of acute macular neuroretinopathy with multifocal electroretinogram and optical coherence tomography

A 34-year-old woman, with preceding flu-like febrile illness, developed acute macular neuroretinopathy in her left eye with typical reddish brown macular lesions and a dense paracentral scotoma. Her condition was evaluated with multifocal electroretinogram and optical coherence tomography in her acute and recovery phases. The findings assist ophthalmologists striving for better understanding and diagnosis of acute macular neuroretinopathy.

Scanning laser ophthalmoscope findings in acute macular neuroretinopathy

PURPOSE: The typical reddish-brown retinal lesions of acute macular neuroretinopathy are difficult to detect. We demonstrate a role for scanning laser ophthalmoscopy in the diagnosis of acute macular neuroretinopathy. METHODS: Observational case report. We used scanning laser ophthalmoscopy in a 23-year-old woman with acute macular neuroretinopathy. RESULTS: In contrast to biomicroscopy, color fundus photography, and red-free fundus photography, scanning laser ophthalmoscopy precisely disclosed the size of the lesions within the macula. Microperimetry showed absolute scotomata corresponding to the macular lesions. CONCLUSION: Scanning laser ophthalmoscopy enhances the visibility of the retinal lesions in acute macular neuroretinopathy. The lesion size can be determined more precisely, and follow-up of patients is more accurate compared with conventional techniques.