Acute macular neuroretinopathy (literature review)
DOI: 10.32364/2311-7729-2025-25-3-7
R.S. Zhazybaev1, E.L. Sorokin1,2
1Khabarovsk Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk, Russian Federation
2Far Eastern State Medical University, Khabarovsk, Russian Federation
The review is focused on an orphan disease of the central retina — acute macular neuroretinopathy (AMN). For the first time, AMN was described by P.J. Bos and A.F. Deutman in 1975. In 2011, S. Yeh et al. proposed a term "acute macular outer retinopathy". In 2013, owing to optical coherence tomography of the retina, D. Sarraf et al. offered an AMN classification based on a degree of retinal damage. According to it, two types of the disease were distinguished: (1) paracentral acute median maculopathy affecting superficial capillary plexus; (2) basically, acute macular neuroretinopathy when alterations are localized in the deep capillary plexus. AMN is more common in females, and the disease is bilateral in 50% of cases. Etiology and pathogenesis of AMN are still underinvestigated, although most authors agree that malperfusion of retinal capillary plexuses that may be caused by a number of reasons, plays a leading role. A patient with AMN provides nonspecific complaints (decreased visual acuity, central visual field defects, distortion of objects). In some cases, the disease is asymptomatic. Ophthalmoscopy visualizes isolated or multiple drop- or wedge-shaped reddish foci localized mainly in the parafoveal zone. Redless light ophthalmoscopy is better to detect them. In addition to basic methods, special ones (perimetry, optical coherence tomography of the retina etc.) are used to diagnose AMN. AMN is differentially diagnosed with multiple "flying" white spot syndrome, acute zonal occult outer retinopathy, acute idiopathic blind spot enlargement syndrome, acute posterior multifocal placoid pigment epitheliopathy, acute retinal pigment epitheliitis, and central serous chorioretinopathy. As AMN is a self-limiting condition that does not cause a pronounced persistent decrease in visual acuity, it does not require special treatment.
Keywords: macula, acute macular neuroretinopathy, optical coherence tomography.
For citation: Zhazybaev R.S., Sorokin E.L. Acute macular neuroretinopathy (literature review). Russian Journal of Clinical Ophthalmology. 2025;25(3):203–207 (in Russ.). DOI: 10.32364/2311-7729-2025-25-3-7
About the authors:
Ruslan S. Zhazybaev — Ophthalmologist at the Consultative and Diagnostic Department, Khabarovsk Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 211, Tikhookeanskaya str., Khabarovsk, 680033, Russian Federation; ORCID iD 0000-0002-6201-5051
Evgenyi L. Sorokin — D. Sc. (Med.), Professor, Deputy Director for Scientific Work of the Khabarovsk Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 211, Tikhookeanskaya str., Khabarovsk, 680033, Russian Federation; Professor of the Department of General and Clinical Surgery, Far Eastern State Medical University; 35, Murav'ev-Amurskiy str., Khabarovsk, 680000, Russian Federation; ORCID iD 0000 0002-2028-1140
Contact information: Ruslan S. Zhazybaev, e-mail: naukakhvmntk@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 12.07.2024.
Revised 09.08.2024.
Accepted 02.09.2024.
2. Yeh S., Hwang T.S., Weleber R.G. et al. Acute Macular Outer Retinopathy (AMOR): A Reappraisal of Acute Macular Neuroretinopathy Using Multimodality Diagnostic Testing. Arch Ophthalmol. 2011;129(3):360–371. DOI: 10.1001/archophthalmol.2011.22
3. Bhavsar K.V., Lin S., Rahimy E. et al. Acute macular neuroretinopathy: A comprehensive review of the literature. Surv Ophthalmol. 2016;61(5):538–565. DOI: 10.1016/j.survophthal.2016.03.003
4. Introini U., Casalino G., Querques G. et al. Acute macular neuroretinopathy following intranasal use of cocaine. Acta Ophthalmol. 2015;93(3):e239–240. DOI: 10.1111/aos.12585
5. Li M., Zhang X., Ji Y. et al. Acute Macular Neuroretinopathy in Dengue Fever: Short-term Prospectively Followed Up Case Series. JAMA Ophthalmol. 2015;133(11):1329–1333. DOI: 10.1001/jamaophthalmol.2015.2687
6. Munk M.R., Jampol L.M., Cunha Souza E. et al. New associations of classic acute macular neuroretinopathy. Br J Ophthalmol. 2016;100(3):389–394. DOI: 10.1136/bjophthalmol-2015-306845
7. Domènech-López N., Llorenç V., Moll-Udina A. et al. Acute macular neuroretinopathy associated with migraine. Arch Soc Esp Oftalmol (Engl Ed). 2025;100(1):51–54. DOI: 10.1016/j.oftale.2024.10.010
8. Mairot K., Gascon P., Levy N. et al. Acute Macular Neuroretinopathy Associated With Idiopathic Intracranial Hypertension. J Neuroophthalmol. 2024;44(1):e12–e13. DOI: 10.1097/WNO.0000000000001728
9. Brossard-Barbosa N., Quin J., Margolin E. Acute Macular Neuroretinopathy Associated With Acute Syphilitic Infection Mimicking Optic Neuritis. J Neuroophthalmol. 2024;44(1):e10–e11. DOI: 10.1097/WNO.0000000000001691
10. Radwan L.M., Bou Ghanem G.O., Daye G.N. et al. Acute macular neuroretinopathy associated with intravitreal anti-VEGF injection: A case report. Am J Ophthalmol Case Rep. 2022;28:101687. DOI: 10.1016/j.ajoc.2022.101687
11. Iovino C., Damiano L., Simonelli F. et al. Acute macular neuroretinopathy following uncomplicated epiretinal membrane removal. Can J Ophthalmol. 2024;59(4):e395–e397. DOI: 10.1016/j.jcjo.2024.01.010
12. Gass J.D., Hamed L.M. Acute macular neuroretinopathy and multiple evanescent white dot syndrome occurring in the same patients. Arch Ophthalmol. 1989;107(2):189–193. DOI: 10.1001/archopht.1989.01070010195021
13. Rahimy E., Sarraf D. Paracentral acute middle maculopathy spectral-domain optical coherence tomography feature of deep capillary ischemia. Curr Opin Ophthalmol. 2014;25(3):207–212. DOI: 10.1097/ICU.0000000000000045
14. Casalino G., Arrigo A., Romano F. et al. Acute macular neuroretinopathy: pathogenetic insights from optical coherence tomography angiography. Br J Ophthalmol. 2019;103(3):410–414. DOI: 10.1136/bjophthalmol-2018-312197
15. Sarraf D., Rahimy E., Fawzi A.A. et al. Paracentral acute middle maculopathy: a new variant of acute macular neuroretinopathy associated with retinal capillary ischemia. JAMA Ophthalmol. 2013;131(10):1275–1287. DOI: 10.1001/jamaophthalmol.2013.4056
16. Abu El-Asrar A.M., Herbort C.P., Tabbara K.F. Differential diagnosis of retinal vasculitis. Middle East Afr J Ophthalmol. 2009;16(4):202–218. DOI: 10.4103/0974-9233.58423
17. Masjedi M., Pourazizi M., Hosseini N.S. Acute macular neuroretinopathy as a manifestation of coronavirus disease 2019: A case report. Clin Case Rep. 2021;9(10):e04976. DOI: 10.1002/ccr3.4976
18. Ng X.L., Betzler B.K., Testi I. et al. Ocular Adverse Events After COVID-19 Vaccination. Ocul Immunol Inflamm. 2021;29(6):1216–1224. DOI: 10.1080/09273948.2021.1976221
19. von der Burchard C., Gruben A., Roider J. Optical coherence tomography angiography suggests choriocapillaris perfusion deficit as etiology of acute macular neuroretinopathy. Graefes Arch Clin Exp Ophthalmol. 2024;262(8):2471–2479. DOI: 10.1007/s00417-024-06436-7
20. Turbeville S.D., Cowan L.D., Gass J.D. Acute macular neuroretinopathy: a review of the literature. Surv Ophthalmol. 2003;48(1):1–11. DOI: 10.1016/s0039-6257(02)00398-3
21. Gillies M., Sarks J., Dunlop C. et al. Traumatic retinopathy resembling acute macular neuroretinopathy. Aust N Z J Ophthalmol. 1997;25(3):207–210. DOI: 10.1111/j.1442-9071.1997.tb01393.x
22. Desai U.R., Sudhamathi K., Natarajan S. Intravenous epinephrine and acute macular neuroretinopathy. Arch Ophthalmol. 1993;111(8):1026–1027. DOI: 10.1001/archopht.1993.01090080022009
23. Kerrison J.B., Pollock S.C., Biousse V. et al. Coffee and doughnut maculopathy: a cause of acute central ring scotomas. Br J Ophthalmol. 2000;84(2):158–164. DOI: 10.1136/bjo.84.2.158
24. Miller M.H., Spalton D.J., Fitzke F.W. et al. Acute macular neuroretinopathy. Ophthalmology. 1989;96(2):265–269. DOI: 10.1016/s0161-6420(89)32906-x
25. Sieving P.A., Fishman G.A., Salzano T. et al. Acute macular neuroretinopathy: early receptor potential change suggests photoreceptor pathology. Br J Ophthalmol. 1984;68(4):229–234. DOI: 10.1136/bjo.68.4.229
26. Hashimoto Y., Saito W., Mori S. et al. Increased macular choroidal blood flow velocity during systemic corticosteroid therapy in a patient with acute macular neuroretinopathy. Clin Ophthalmol. 2012;6:1645–1649. DOI: 10.2147/OPTH.S35854
27. Grover S., Brar V.S., Murthy R.K. et al. Infrared imaging and spectral-domain optical coherence tomography findings correlate with microperimetry in acute macular neuroretinopathy: a case report. J Med Case Rep. 2011;5:536. DOI: 10.1186/1752-1947-5-536
28. Gelman R., Chen R., Blonska A. et al. Fundus autofluorescence imaging in a patient with rapidly developing scotoma. Retin Cases Brief Rep. 2012;6(4):345–348. DOI: 10.1097/ICB.0b013e318260af5d
29. Fawzi A.A., Pappuru R.R., Sarraf D. et al. Acute macular neuroretinopathy: long-term insights revealed by multimodal imaging. Retina. 2012;32(8):1500–1513. DOI: 10.1097/IAE.0b013e318263d0c3
30. Sieving P.A., Fishman G.A., Salzano T. et al. Acute macular neuroretinopathy: early receptor potential change suggests photoreceptor pathology. Br J Ophthalmol. 1984;68(4):229–234. DOI: 10.1136/bjo.68.4.229
31. Hansen S.O., Cooper R.F., Dubra A. et al. Selective cone photoreceptor injury in acute macular neuroretinopathy. Retina. 2013;33(8):1650–1658. DOI: 10.1097/IAE.0b013e31828cd03a
32. Mrejen S., Pang C.E., Sarraf D. et al. Adaptive optics imaging of cone mosaic abnormalities in acute macular neuroretinopathy. Ophthalmic Surg Lasers Imaging Retina. 2014;45(6):562–569. DOI: 10.3928/23258160-20141118-12
33. Neuhann I.M., Inhoffen W., Koerner S. et al. Visualization and follow-up of acute macular neuroretinopathy with the Spectralis HRA+OCT device. Graefes Arch Clin Exp Ophthalmol. 2010;248(7):1041–1044. DOI: 10.1007/s00417-010-1324-y
34. Garg A., Shah A.N., Richardson T. et al. Early features in acute macular neuroretinopathy. Int Ophthalmol. 2014;34(3):685–688. DOI: 10.1007/s10792-013-9850-3
35. Azar G., Wolff B., Cornut P.L. et al. Spectral domain optical coherence tomography evolutive features in acute macular neuroretinopathy. Eur J Ophthalmol. 2012;22(5):850–852. DOI: 10.5301/ejo.5000172
36. Monson B.K., Greenberg P.B., Greenberg E. et al. High-speed, ultra-high-resolution optical coherence tomography of acute macular neuroretinopathy. Br J Ophthalmol. 2007;91(1):119–120. DOI: 10.1136/bjo.2006.098871
37. Goldenberg D., Habot-Wilner Z., Loewenstein A. et al. Spectral domain optical coherence tomography classification of acute posterior multifocal placoid pigment epitheliopathy. Retina. 2012;32(7):1403–1410. DOI: 10.1097/IAE.0b013e318234cafc
38. Мальцев Д.С. Количественная оптическая когерентная томография-ангиография в диагностике парацентральной острой срединной макулопатии и острой макулярной нейроретинопатии. Современные технологии в офтальмологии. 2017;(7):55–57. Maltsev D.S. Quantitative optical coherence tomography-angiography in the diagnosis of paracentral acute median maculopathy and acute macular neuroretinopathy. Modern technologies in ophthalmology. 2017;(7):55–57 (in Russ.).
39. Gass J.D., Agarwal A., Scott I.U. Acute zonal occult outer retinopathy: a long-term follow-up study. Am J Ophthalmol. 2002;134(3):329–339. DOI: 10.1016/s0002-9394(02)01640-9
40. Rodman J.A., Shechtman D.L., Haines K. Acute macular neuroretinopathy: the evolution of the disease through the use of newer diagnostic modalities. Clin Exp Optom. 2014;97(5):463–467. DOI: 10.1111/cxo.12161
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Распечатать