Clinical features of acute macular neuroretinopathy
10.3760/cma.j.issn.1005-1015.2016.02.013
- VernacularTitle:急性黄斑神经视网膜病变的临床特征
- Author:
Miaoling LI
;
Xiongze ZHANG
;
Yuying JI
;
Baikang YE
;
Feng WEN
- Publication Type:Journal Article
- Keywords:
Macula lutea/injuries;
Retinal diseases/ diagnosis;
Disease attributes
- From:
Chinese Journal of Ocular Fundus Diseases
2016;32(2):169-171
- CountryChina
- Language:Chinese
-
Abstract:
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.
