Adaptive optics imaging of cone mosaic abnormalities in acute macular neuroretinopathy

Ophthalmic Surg Lasers Imaging Retina. 2014 Nov-Dec;45(6):562-9. doi: 10.3928/23258160-20141118-12.


Background and objective: To assess the cone photoreceptor mosaic in acute macular neuroretinopathy (AMN) using adaptive optics (AO) imaging.

Patients and methods: Four patients with AMN were evaluated retrospectively by near-infrared reflectance (IR) confocal scanning laser ophthalmoscopy (SLO), spectral-domain optical coherence tomography (SD-OCT), and a flood-illuminated retinal AO camera. Microperimetry was performed in one patient.

Results: The cone photoreceptor density was decreased at the level of the AMN lesions. The cone mosaic disruption appeared heterogeneous and more widespread than the lesion detected in the IR-SLO and SD-OCT images. The areas of cone loss correlated with SD-OCT and microperimetry. After resolution of the AMN lesion on IR-SLO, there was incomplete recovery of the cone photoreceptor mosaic.

Conclusion: Cone photoreceptor damage and reconstitution were documented in vivo at the cellular level in AMN using AO imaging. AO imaging appeared more sensitive than combined IR-SLO and SD-OCT to detect and follow photoreceptor damage in patients with AMN.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Diagnostic Techniques, Ophthalmological*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging*
  • Ophthalmoscopy
  • Photography
  • Retinal Cone Photoreceptor Cells / pathology*
  • Retinal Diseases / diagnosis*
  • Retinal Diseases / physiopathology
  • Retrospective Studies
  • Scotoma / diagnosis
  • Scotoma / physiopathology
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology
  • Young Adult