Functional and high-resolution retinal imaging monitoring photoreceptor damage in acute macular neuroretinopathy

Graefes Arch Clin Exp Ophthalmol. 2016 May;254(5):855-64. doi: 10.1007/s00417-015-3136-6. Epub 2015 Sep 7.


Background: To report functional and high-resolution retinal imaging abnormalities, including adaptive optics (AO) throughout the course of acute macular neuroretinopathy (AMNR).

Methods: Two female patients (four eyes) with a diagnosis of AMNR were observed at the Clinical Investigation Center, CHNO des Quinze-Vingts, Paris, France. The patients underwent detailed ophthalmic examination including best-corrected visual acuity, slit-lamp examination, kinetic and static perimetry, full-field and multifocal electroretinogram, infrared reflectance, autofluorescence imaging and spectral-domain optical coherence tomography (SD-OCT) and AO fundus imaging at presentation and during follow-up.

Results: Both cases showed concomitant loss of integrity of the outer retinal structures on SD-OCT, and marked abnormalities on AO imaging with disruption of the visibility of the cone mosaic. In the first case, photoreceptor damage was seen to progress during several weeks before healing. In both cases, there were persistent morphological abnormalities of photoreceptors 1 year after onset.

Conclusion: This study further highlights the value of AO fundus imaging to facilitate detection, mapping, and monitoring of damage to the cone outer segments during AMNR. In particular, residual damage to the cone mosaic can be precisely documented.

Keywords: Acute macular neuroretinopathy; Adaptive optics; High-resolution retinal imaging; Multimodal retinal imaging; SD-OCT.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adolescent
  • Diagnostic Imaging
  • Electroretinography
  • Female
  • Fluorescein Angiography
  • Humans
  • Photoreceptor Cells, Vertebrate / pathology*
  • Retinal Diseases / diagnostic imaging*
  • Retinal Diseases / physiopathology*
  • Scotoma / physiopathology
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Young Adult