Multimodality diagnostic imaging in unilateral acute idiopathic maculopathy

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Imaging

Background:

• Unilateral acute idiopathic maculopathy (UAIM) is a rare condition affecting the macula.
• Understanding its clinical and imaging features is crucial for diagnosis and management.

Purpose of the Study:

• To detail the clinical presentation and spectral-domain optical coherence tomography (SD-OCT) and angiography findings in UAIM.
• To correlate imaging findings with visual outcomes and disease pathogenesis.

Main Methods:

• Retrospective analysis of four patients diagnosed with UAIM.
• Evaluation of clinical data, visual acuity, and multimodal imaging including SD-OCT, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography.

Main Results:

• Patients presented with significant vision loss (median 20/400), often following a viral prodrome.
• Imaging revealed characteristic macular discoloration, outer retinal disruption on SD-OCT, and choroidal inflammation on indocyanine green angiography.
• Visual acuity improved significantly (median 20/30) with resolution of imaging findings.

Conclusions:

• UAIM exhibits specific structural changes during active and resolving phases.
• Pathogenesis likely involves inflammation of the inner choroid, RPE, and photoreceptors.
• Partial reversibility of structural changes correlates with visual recovery.