Enhanced Depth Imaging OCT and Indocyanine Green Angiography Changes in Acute Macular Neuroretinopathy

Sanjari, Nasrin; Moein, Hamid Reza; Soheilian, Roham; Soheilian, Masoud; Peyman, Gholam A.

doi:10.3928/23258160-20131101-07

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…8 Compression and nonperfusion of small choroidal vessels caused by massive infiltration of inflammatory cells and stromal granulomas in the acute stage and shrinkage and dropout of the small choroidal vessels by the stromal scarring in the convalescent phase may contribute to the mechanism of this finding. 9 Similar findings were detected in our patient.…”

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confidence: 99%

“…However, few studies regarding morphology of the choroid in AMN patients have been reported. 8 We examined changes in morphology and circulation in the choroid of an AMN patient using enhanced-depth imaging OCT (EDI-OCT) and LSFG.An 11-year-old girl reported a paracentral scotoma of the right eye, first noted 3 months prior to presentation at our clinic. The patient's medical and family histories were unremarkable.…”

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Enhanced-depth Imaging Optical Coherence Tomography and Laser Speckle Flowgraphy in a Patient with Acute Macular Neuroretinopathy

Hirooka¹,

Saito

Noda

et al. 2014

Ocular Immunology and Inflammation

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Acute macular neuroretinopathy (AMN) is a rare disease characterized by a wedge-shaped dark reddish-brown lesion at the macula. 1 Spectral domain optical coherence tomography (OCT) images have shown that AMN lesions mainly affect the outer retina. 2,3 AMN lesions can be visualized clearly using scanning laser ophthalmoscope (SLO) infrared imaging, 2,3 a noninvasive technique used to characterize structural changes at the level of the retinal pigment epithelium-inner choroid layers. The data collected thus far suggest that AMN lesions typically extend from the outer retina to the inner choroid.In a recent study using SD-OCT, AMN was classified into type 1 or 2 by whether hyperreflective bands corresponding to the lesions were located above or below the outer plexiform layer. 4 Type 2 appears to involve the outer retinal impairments but type 1 does not and was especially named as paracentral acute middle maculopathy. 4 The mechanism was speculated to be the occlusion of the superficial (type 1) or deep (type 2) retinal capillary plexus. In the study, however, pathology regarding the choroid, which supplies the oxygen and nutrient to the photoreceptor, was not examined.Laser speckle flowgraphy (LSFG) can be used for noninvasive evaluation of circulation of ocular tissues and calculation of the mean blur rate (MBR), a quantitative index of relative blood flow velocity. 5 Since the MBR originates mainly from the choroid, this value is associated with choroidal hemodynamics, particularly at the macula. LSFG is a suitable device to quantitatively monitor changes in ocular tissue circulation during the course of various diseases 5 because it provides a relative value for the blood flow. We used LSFG to show that choroidal blood flow velocity decreased at the lesion site during the acute phase of AMN. 6 This result suggests that impaired choroidal circulation is involved in the pathogenesis of AMN. Furthermore, we recently reported a case with the simultaneous onset of AMN and central retinal vein occlusion, 7 suggesting that circulatory disorder concurrently occurred in retinal and choroidal vessels. However, few studies regarding morphology of the choroid in AMN patients have been reported. 8 We examined changes in morphology and circulation in the choroid of an AMN patient using enhanced-depth imaging OCT (EDI-OCT) and LSFG.An 11-year-old girl reported a paracentral scotoma of the right eye, first noted 3 months prior to presentation at our clinic. The patient's medical and family histories were unremarkable.The patient's best-corrected visual acuity (BCVA) was 1.5 OU with mild hyperopia of the same degree. Slit-lamp examination revealed no abnormal findings OU. There were no abnormal funduscopic findings OS. Funduscopic examination revealed a petaloid dark reddish lesion at the upper edge of the fovea ( Figure 1A). SLO infrared imaging showed a dark area corresponding to the site of the dark reddish lesion ( Figure 1B). Fluorescein angiography (FA) revealed hypofluorescence from the initial phase

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Enhanced-depth Imaging Optical Coherence Tomography and Laser Speckle Flowgraphy in a Patient with Acute Macular Neuroretinopathy

Hirooka¹,

Saito

Noda

et al. 2014

Ocular Immunology and Inflammation

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“…Based on the abnormal images of NIR imaging, AMN was considered to involve RPE. Sanjari et al [25] found the angiographic images of choroidal angiography showed enhanced permeability and prominentchoroid; the OCT images showed increased thickness of the choroid and irregular junction in the macular area, indicating that AMN lesions can involve the choroid. It is considered that the cause of AMN may come from the choroid, so it is recommended to classify it as choroidal disease.…”

Section: Acute Macular Neuroretinopathy Following Sars-cov-2 Infectionmentioning

confidence: 99%

Clinical and multimodal imaging features of acute macular neuroretinopathy lesions following recent SARS-CoV-2 infection

Liu¹,

Wang²,

Chen³

2023

Int J Ophthalmol

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AIM: To describe the clinical characteristics of eyes using multimodal imaging features with acute macular neuroretinopathy (AMN) lesions following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: Retrospective case series study. From December 18, 2022 to February 14, 2023, previously healthy cases within 1-week infection with SARS-CoV-2 and examined at Tianjin Eye Hospital to confirm the diagnosis of AMN were included in the study. Totally 5 males and 9 females [mean age: 29.93±10.32 (16-49)y] were presented for reduced vision, with or without blurred vision. All patients underwent best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscopy, indirect fundoscopy. Simultaneously, multimodal imagings fundus photography (45° or 200° field of view) was performed in 7 cases (14 eyes). Near infrared (NIR) fundus photography was performed in 9 cases (18 eyes), optical coherence tomography (OCT) in 5 cases (10 eyes), optical coherence tomography angiography (OCTA) in 9 cases (18 eyes), and fundus fluorescence angiography (FFA) in 3 cases (6 eyes). Visual field was performed in 1 case (2 eyes). RESULTS: Multimodal imaging findings data from 14 patients with AMN were reviewed. All eyes demonstrated different extent hyperreflective lesions at the level of the inner nuclear layer and/or outer plexus layer on OCT or OCTA. Fundus photography (45° or 200° field of view) showed irregular hypo-reflective lesion around the fovea in 7 cases (14 eyes). OCTA demonstrated that the superficial retinal capillary plexus (SCP) vascular density, deep capillary plexus (DCP) vascular density and choriocapillaris (CC) vascular density was reduced in 9 case (18 eyes). Among the follow-up cases (2 cases), vascular density increased in 1 case with elevated BCVA; another case has vascular density decrease in one eye and basically unchanged in other eye. En face images of the ellipsoidal zone and interdigitation zone injury showed a low wedge-shaped reflection contour appearance. NIR image mainly show the absence of the outer retinal interdigitation zone in AMN. No abnormal fluorescence was observed in FFA. Corresponding partial defect of the visual field were visualized via perimeter in one case. CONCLUSION: The morbidity of SARS-CoV-2 infection with AMN is increased. Ophthalmologists should be aware of the possible, albeit rare, AMN after SARS-CoV-2 infection and focus on multimodal imaging features. OCT, OCTA, and infrared fundus phase are proved to be valuable tools for detection of AMN in patients with SARS-CoV-2.

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Acute macular neuroretinopathy misdiagnosed as optic neuritis

et al. 2014

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This study aims to report a case of acute macular neuroretinopathy (AMN) misdiagnosed as optic neuritis. The methods include review of the clinical, photographic, angiographic, visual field, infrared imaging, and optical coherence tomography records of a patient with AMN. A 30-year-old female who was initially diagnosed with optic neuritis and at first was treated with systemic corticosteroid because of this misdiagnosis. She was admitted with no decrease in her complaint of central scotoma in both eyes. Her visual acuities were 20/20 and fundoscopy showed reddish brownish pigment changes in the macula of both eyes. Infrared (IR) imaging disclosed bilateral hyporeflective lesions, optical coherence tomography revealed a disrupted inner segment-outer segment junction of the right eye, and visual field assessment showed central scotomas in both eyes. Three years later, fundus examination of the hyporeflective lesions by IR imaging revealed that the lesions had decreased and were only slightly perceptible. This rare case is presented to focus the attention of clinicians and to emphasize the importance of careful ophthalmic examination and imaging techniques.

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Enhanced Depth Imaging OCT and Indocyanine Green Angiography Changes in Acute Macular Neuroretinopathy

Cited by 7 publications

References 16 publications

Enhanced-depth Imaging Optical Coherence Tomography and Laser Speckle Flowgraphy in a Patient with Acute Macular Neuroretinopathy

Enhanced-depth Imaging Optical Coherence Tomography and Laser Speckle Flowgraphy in a Patient with Acute Macular Neuroretinopathy

Clinical and multimodal imaging features of acute macular neuroretinopathy lesions following recent SARS-CoV-2 infection

Acute macular neuroretinopathy misdiagnosed as optic neuritis

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