Traumatic retinopathy presenting as acute macular neuroretinopathy

Traumatic retinopathy presenting as acute macular neuroretinopathy (AMNR) is an uncommon disease causing paracentral scotomas after indirect trauma.

We report on five patients (six eyes) with AMNR with a temporary reduction of visual acuity and persistent paracentral scotomas after indirect trauma. The findings were documented using multimodal imaging and the follow-up was up to 32 months.

Initially, fundoscopy was unremarkable in all patients while visual acuity (Snellen equivalents) varied between 0.03 and 1.0, and a paracentral scotoma was present in all patients. During follow-up, visual acuity recovered to 1.0 in all patients while the paracentral scotomas persisted. Spectral-domain optical coherence tomography revealed a disruption of the inner/outer segment junction within the macular lesion and changes in the outer nuclear layer, which slowly recovered partly during the follow-up.

These findings suggest that indirect trauma can cause changes in the outer retina resembling those seen in AMNR, resulting in persisting paracentral scotomas.