C-Shaped Scotoma after Complicated Cesarean Section: A Case of Acute Macular Neuroretinopathy

Case Rep Ophthalmol. 2019 Nov 26;10(3):391-396. doi: 10.1159/000504289. eCollection 2019 Sep-Dec.

Abstract

Acute macular neuroretinopathy (AMN) is a rare retinal disease that produces transient or permanent visual impairment and occurs predominantly in young, Caucasian women of childbearing age. It is often characterized by wedge-like macular lesions. Although the cause of AMN is unknown, recent research suggests a microvascular etiology. Various vascular pathologies, including post-viral illness, oral contraceptives, and use of vasoconstrictive agents, have been associated with AMN. We present a case of a woman with C-shaped visual field defects in both eyes after inadvertent exposure to intravenous high-dose epinephrine during onset of spinal anesthesia. At present, only 8 cases of AMN after exposure to epinephrine have been described in literature. To our knowledge, this is the first case of AMN that presented following epinephrine injection during childbirth.

Keywords: Acute macular neuroretinopathy; Cesarean section; Epinephrine; Retinal microvasculature; Spectral-domain optical coherence tomography.

Publication types

  • Case Reports