Acute Macular Neuroretinopathy Following Intravenous Sympathomimetics

O'Brien, D.B.; Farmer, Samuel G.; Kalina, Robert E.; Leon, John Mark de

doi:10.1097/00006982-198909040-00008

Cited by 46 publications

(15 citation statements)

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“…The cause of AMNR is not known, but both inflammatory19-21 and vasculopathic12 14 24 mechanisms have been proposed. In support of an inflammatory process is the observation that most cases occur in young women and that many affected individuals report having had an antecedent viral illness 15-17…”

Section: Discussionmentioning

confidence: 99%

“…In support of an inflammatory process is the observation that most cases occur in young women and that many affected individuals report having had an antecedent viral illness 15-1719 20 Other cases occurred in the setting of allergic drug reactions 1213The development of lesions characteristic of multiple evanescent white dot syndrome (MEWDS), either simultaneously or years after the appearance of macular lesions characteristic of AMNR21 has prompted the inclusion of AMNR among the inflammatory disorders grouped together as acute zonal occult outer retinopathy (AZOOR) 24…”

Section: Discussionmentioning

confidence: 99%

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Coffee and doughnut maculopathy: a cause of acute central ring scotomas

Kerrison

Pollock²,

Biousse³

et al. 2000

British Journal of Ophthalmology

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Aims-To report the clinical features of five patients with non-progressive central ring scotomas of acute onset associated with excellent retained visual acuity. Methods-Complete neuro-ophthalmological examinations were performed. Visual fields were performed by tangent screen, Goldmann, or Humphrey perimetry. In some cases further testing was carried out including fundus photography, fluorescein angiography, ERG, VEP, and neuroimaging. Results-The patients were three women and two men whose ages ranged from 25 to 57 years. Four patients were heavy caVeine consumers while the fifth patient experienced an episode of hypotension. Vision loss was acute in all cases. The onset of vision loss was bilateral/simultaneous in three cases, bilateral/sequential in one case, and unilateral in one case. All aVected eyes retained visual acuities of 20/25 or better. Colour vision was subnormal in three of four cases. Visual field defects were characterised by a central ring scotoma having an outer diameter less than 10 degrees. Fundus examination demonstrated temporal optic nerve pallor in three patients (five of 10 aVected eyes) and reddish, petaloid macular lesions in one patient. Good visual acuity was maintained for the duration of follow up in all five patients. Conclusion-Central ring scotomas with excellent retained visual acuity may present as an acute, bilateral syndrome in patients who are heavy caVeine consumers. The configuration of visual field loss and its location, combined with the presence of temporal pallor in five eyes, suggest that the defect localises to the inner layers of the macula. While these cases could be considered an expansion of the clinical spectrum of acute macular neuroretinopathy, some may represent a distinct entity. (Br J Ophthalmol 2000;84:158-164)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Coffee and doughnut maculopathy: a cause of acute central ring scotomas

Kerrison

Pollock²,

Biousse³

et al. 2000

British Journal of Ophthalmology

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“…Bos and Deutman 1 has been followed by numerous reports implicating precipitants including, most commonly, an acute viral illness 1,2 but also the administration of vasoconstricting drugs 3 and acute systemic hypotensive episodes. 4 Although Bos and Deutman 1 originally proposed a lesion in the inner retina, Figure 2 Colour fundus photographs and infra-red images at presentation, 2 weeks after the onset of symptoms.…”

Section: Correspondencementioning

confidence: 99%

Acute macular neuroretinopathy: anatomic localisation of the lesion with high-resolution OCT

2009

Eye

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“…A thin retinal blood layer has been discussed but seems unlikely due to normal angiographic findings in most of the patients, except a very slight hypofluorescence and not a dramatically blocked flourescence that would be expected from blood (Kalina 1999). Nonetheless, a vascular etiology has been discussed as patients with acute hypertension caused by intravenous sympathomimetics (O'Brien et al 1989), patients receiving a contrast agent for computed tomography (Guzak et al 1983), as well as patients with eclampsia (Kalina 1999) and oral contraceptive use (Desai et al 1993) have been described to resemble AMN. Recently, heavy caffeine consumption as well as hypotension have been published as additional causes in AMN (Kerrison et al 2000).…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography (OCT) in acute macular neuroretinopathy

Feigl

Haas

2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To evaluate the value of ocular coherence tomography (OCT) concerning diagnosis and pathogenesis of acute macular neuroretinopathy. Methods: A 33-year old woman complained of sudden onset of central scotomas in her right eye because of acute macular neuroretinopathy. We performed a direct ophthalmoscopy, a visual field testing, a fluorescein angiography (FA) a multifocal ERG (mf-ERG) and an OCT. Results: We found typical paracentral scotoma in visual field testing, a normal FA and mf-ERG in her right eye. In OCT there was a band of higher reflectivity (115 mm) overlying an intact band corresponding to the retinal pigment epithelium (RPE)/ choriocapillaris complex. Retinal thickness was within the normal range. Conclusion: OCT can be an additional valuable tool in acute macular neuroretinopathy as it is a disease with discrete pathology and often normal results in other diagnostic tests. A cute macular neuroretinopathy was first discribed by Bos and Deutmann in 1975 and is a rare uni-or bilateral maculopathy of unknown etiology involving mainly young women between the ages of 20 and 30 years. Most patients experience sudden onset of paracentral scotomas with preserved good visual acuity, often with a preceding flu-like disease (Bos & Deutmann 1975;Miller et al. 1989). Ophthalmoscopy shows wedgeshaped, red-brown lesions arranged radially in the macula. The lesions are suggested to be located in the outer retina, FA and standard electroretinography (Sieving et al. 1984) typically are normal, whereas Amsler grid and visual fields reveal parafoveal scotomas. Visual deficit does not improve as persistance of maculopathy and scotomas have been described up to 9 years (Desai et al.1993) and a benefit of any medical treatment (e.g steroids) has not been proven to date. Case ReportA 33-year-old female patient complained about sudden visual disturbances with central, greyish, swirling scotomas on her right eye. A week before she had suffered from a flu-like disease with fever, swelling of the left submandibular lymph nodes, and pain in her joints. Other than taking oral antibiotics after the onset of visual problems, she did not receive any treatment.Visual acuity was 20/20 on her right eye; on her left eye she had a decreased visual acuity (20/100) because of squinting as a child and amblyopia. Amsler grid examination showed metamorphopsia in the temporal superior area on her right eye. Direct ophthalmoscopy revealed red-brown lesions (Fig. 1) in the macula area and visual field testing (Octopus M2, Interzeag, Switzerland) showed paracentral scotomas (Fig. 2) while the results on her left eye were within the normal range. First order Kernels of mf-ERG (Reti scan, Roland Consult, Wiesbaden, Germany) were normal

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Acute Macular Neuroretinopathy Following Intravenous Sympathomimetics

Cited by 46 publications

References 0 publications

Coffee and doughnut maculopathy: a cause of acute central ring scotomas

Coffee and doughnut maculopathy: a cause of acute central ring scotomas

Acute macular neuroretinopathy: anatomic localisation of the lesion with high-resolution OCT

Optical coherence tomography (OCT) in acute macular neuroretinopathy

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