Major reviewAcute Macular Neuroretinopathy: A Review of the Literature
Section snippets
Definition, Clinical Diagnosis, and Natural History of AMNR
Acute macular neuroretinopathy (AMNR) is a rare condition characterized by the sudden onset of mild visual impairment from lesions that occur in the macula of the retina.4 It occurs unilaterally or bilaterally with normal to mildly decreased visual acuity.1, 4, 11, 19, 24, 26, 28, 30 Patients typically present several days or later after the development of multiple, paracentral scotomata in one or both eyes.4, 11, 24, 28
The clinical diagnosis is readily made on the basis of the distinctive
Summary of Reported Cases
AMNR is rare. Forty-one cases have been reported to date in the English-language medical literature from 1975 through April 2002. These cases are summarized in Table 1. AMNR is seen more frequently in women than men; of the 41 cases, 34 (83%) were in women.1, 4, 10, 11, 17, 19, 24, 26, 29, 30, 31 Women were in their reproductive years, with a mean age of 27 years (range 20–53 years).1, 4, 10, 11, 17, 19, 24, 26, 29, 30, 31 We were unable to identify any published reports of AMNR in children.
Summary
Acute macular neuroretinopathy is a rare condition that had been reported primarily among young women in their reproductive years. The symptoms usually include the onset of temporary or permanent vision loss associated with paracentral scotomas that occur either unilaterally or bilaterally. The hallmark lesions of this condition are dark-reddish brown and wedge- or oval-shaped. The lesions typically point toward the fovea and appear as teardrops or petals. Amsler grid or Goldmann perimetry
Method of Literature Search
This review included all published case reports of AMNR in the English-speaking literature from 1975 through April 2002. The following databases were searched: Pubmed and Medline. The keywords included acute macular neuroretinopathy, macula, etiology, and retinal diseases. Textbooks that included information on diseases of the macula were examined for relevant reports, and published reports identified through the reference lists of other articles were also included. Only non-English language
Acknowledgements
The authors reported no proprietary or commercial interest in any product mention or concept discussed in this article.
References (37)
- et al.
Acute macular neuroretinopathy
Am J Ophthalmol
(1975) - et al.
Scanning laser ophthalmoscope findings in acute macular neuroretinopathy
Am J Ophthalmol
(2002) - et al.
Visual field loss in migraine
Ophthalmology
(1989) - et al.
Acute macular neuroretinopathy
Ophthalmology
(1989) - et al.
Acute macular neuroretinopathy
Am J Ophthalmol
(1978) Acute macular neuroretinopathy
Am J Ophthalmol
(1977)- et al.
Acute idiopathic blind spot enlargement. A spectrum of disease
Ophthalmology
(1991) Acute macular neuroretinopathy
Arch Ophthalmol
(1998)- et al.
Acute macular neuroretinopathy
Arch Ophthalmol
(1998) Amaurosis fugax in a young woman
Lancet
(1990)
MigraineManifestations, Pathogenesis, and Management
Intravenous epinephrine and acute macular neuroretinopathy
Arch Ophthalmol
Inner retinal layer loss in complicated migraine. Case report
Arch Ophthalmol
Optical coherence tomography (OCT) in acute macular neuroretinopathy
Acta Ophthalmol Scand
Transient monocular blindness versus amaurosis fugax
Neurology
Acute macular neuroretinopathy and multiple evanescent white dot syndrome occurring in the same patients
Arch Ophthalmol
Stereoscopic Atlas of Macular DiseaseDiagnosis and Treatment
Stereoscopic Atlas of Macular DiseaseDiagnosis and Treatment
Cited by (112)
The OCT angular sign of Henle fiber layer (HFL) hyperreflectivity (ASHH) and the pathoanatomy of the HFL in macular disease
2023, Progress in Retinal and Eye ResearchCitation Excerpt :However, persistent visual field deficits have been reported in more than 50% of patients (Bhavsar et al., 2016). There is no specific treatment and no consensus regarding the discontinuation of risk factors such as hormonal contraceptives after AMN (Bhavsar et al., 2016; Fawzi et al., 2012; Turbeville et al., 2003). The nature of the primary insult in AMN remains uncertain and both ischemic and inflammatory disruption have been suggested.
Acute Macular Neuroretinopathy and Coronavirus Disease 2019
2023, Ophthalmology RetinaCoincident PAMM and AMN and Insights Into a Common Pathophysiology
2022, American Journal of OphthalmologyCitation Excerpt :The exact etiology of AMN, however, remains elusive, albeit a wealth of evidence suggests a vasculopathic etiology.22-24 Specifically, Turbeville and associates hypothesized vascular damage as a common end point of vasoactive events including exposure to epinephrine, trauma, hypovolemia, systemic shock, hyperviscosity, contraceptive use, and occlusion of precapillary arterioles by immune complex deposition.4,25 OCTA in AMN has displayed flow deficits at the deepest level of the DCP, suggesting that capillary injury at the level of the collecting venules may be the primary etiology.10,16,26
Acute macular neuroretinopathy associated with acute promyelocytic leukemia
2021, American Journal of Ophthalmology Case ReportsCitation Excerpt :Affected patients classically present with acute paracentral scotomas, mild vision loss, and perifoveal reddish, wedge-shaped petalloid lesions on exam. Other risk factors commonly reported with AMN include viral prodrome, exposure to vasoconstrictive epinephrine or ephedrine, caffeine intake, and hypotensive shock.2,3 To date, there has been one other report in the literature describing AMN in the setting of acute lymphoblastic leukemia (ALL).4
Whitcup and Nussenblatt’s Uveitis: Fundamentals and Clinical Practice
2021, Whitcup and Nussenblatt's Uveitis: Fundamentals and Clinical PracticeAcute macular outer retinopathy: Contribution of optical coherence tomography-angiography (OCT-A)
2021, Journal Francais d'Ophtalmologie