Acute Macular Neuro-retinopathy: a Rare Retinal Disorder, Presenting as Paracentral Scotoma

Doi: 10.36351/pjo.v37i3.1225

Abstract

Acute Macular Neuro-retinopathy (AMN) is a rare clinical entity. We present a case of 26 years old male who presented with one-week old history of sudden onset of decrease vision in left eye associated with paracentral scotomas. Dilated fundus examination of the left eye showed multiple reddish brownish petalloid para-foveal lesions with apex pointing toward the fovea. OCT showed hyper-reflective bands in the Outer Nuclear Layer and Outer Plexiform Layer along with disruption of ellipsoid zones. Amsler grid drawn by the patient and the visual field showed scotoma corresponding to the macular lesion. The cause turned out to be undiagnosed essential hypertension. Purpose of presenting this case is that High Definition Optical coherence tomography (SD-OCT) makes diagnosis of some rare conditions easy and fast for an ophthalmologist, that might be misdiagnosed or missed with conventional OCT and FFA imaging test.

Key Words:  Acute Macular Neuro-retinopathy, Spectral Domain Optical Coherence Tomography, Paracentral Scotoma.