[Acute Macular Neuroretinopathy]

Acute macular neuroretinopathy (AMNR) is a rare unilateral or bilateral macular disorder. It typically occurs in young women presenting with sudden onset of central scotomas. They correspond to sharp reddish-brown areas in the macular region. The lesions often can only be observed with infrared reflectance imaging. These flat oval or wedge-shaped lesions are often grouped as a flower around the fovea.

Retrospective case series of 4 patients with AMNR. Clinical morphological features using different imaging techniques are presented.

Four young women (26, 27, 28, 29 years of age) complained of seeing dark spots in the central visual field. In 3 patients, the scotomas occurred bilaterally. Three patients reported a history of preceding flu-like illness. In all 4 cases, visual acuity in both eyes was 1.0 with normal anterior and posterior segments. The corresponding retinal lesions were only noted in the infrared image of the optical coherence tomography (OCT). OCT images showed focal abnormalities in the photoreceptor outer segments. Follow-up periods varied between 9 and 36 months. In all patients, symptoms improved with at least partial recovery of the retinal architecture.

Patients with AMNR suffer from acute onset of unilateral or bilateral central scotomas. Visual acuity is often only mildly affected. AMNR has a variable prognosis. In some cases, a self-limiting course with retinal recovery is observed while some patients have persistent reduction in visual acuity. Because there is no causative treatment for AMNR, an observational treatment approach is generally recommended.