FIGURE 161.1 This 42-year-old woman presented with a 3-week history of a flu-like syndrome before the onset of paracentral scotomas in the left eye. [doctorlib.info]

Symptoms Patients present with the sudden onset of 1 or more petal-shaped paracentral scotomas, usually involving only 1 eye, but rarely both eyes are affected. There are no other visual or ocular symptoms. [eyewiki.aao.org]

In another case, the scotomata were still present at 9 years, although at this time they were less dense. [aaojournal.org]

• Pharyngitis

  Many of these patients are taking birth control pills.[1,3-5,11-15,17-20] The visual disturbance is often preceded by a bout of a flu-like syndrome, such as influenza, pharyngitis, or enteritis.[1,4,5,9,11,12,14,19-22] When patients are tested with the [doctorlib.info]

  Risk Factors Many associations have been identified with AMN and include: Infection or febrile illness (i.e. influenza, enteritis, upper respiratory tract infection, pharyngitis, bronchitis, dengue fever, etc.) [eyewiki.aao.org]

• Retinal Pigmentation

  Krill AE, Deutman AF: Acute retinal pigment epitheliitis. Am J Ophthalmol 1972; 74:193. 25. Deutman AF: Acute retinal pigment epitheliitis. Am J Ophthalmol 1974; 78:571. 26. Friedman MW: Bilateral recurrent acute retinal pigment epitheliitis. [doctorlib.info]

  Acute Retinal Pigment Epitheliitis (Krill's disease) 2. Multiple Evanescent White Dot Syndrome (MEWDS) 3. Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) 4. Central Serous Chorioretinopathy (CSCR) 5. Optic Neuritis 6. [eyewiki.aao.org]

• Photopsia

  – Other symptoms include: · Scotoma/'shadows'/'spot' · Mild decreased visual acuity ~ 20/30 · Floaters · Metamorphopsia · Photopsia Clinical diagnosis Clinical diagnosis is based on the patient's history and symptoms as described above, generally with [eyewiki.aao.org]

Gass JDM: Stereoscopic atlas of macular diseases: diagnosis and treatment, 2nd edn. St Louis: CV Mosby; 1977:304. 3. Gass JDM, Hamed LM: Acute macular neuroretinopathy and multiple evanescent white dot syndrome occurring in the same patients. [doctorlib.info]

General treatment None. Medical therapy None. Medical follow up Follow-up is at the discretion and comfort level of the physician. [eyewiki.aao.org]

Salzano T Rabb MF Acute macular neuroretinopathy: early receptor potential change suggests photoreceptor pathology.Br J Ophthalmol. 1984; 68: 229-234 Scopus (45) PubMed Crossref Google Scholar Gass JDM Stereoscopic Atlas of Macular Diseases: Diagnosis and Treatment [aaojournal.org]

Prognosis Full resolution of scotomas has never been reported. Some scotomas partially resolve, some do not resolve at all. However, there are no reports of this disease causing meaningful vision loss in an eye. Visual prognosis is usually good. [eyewiki.aao.org]

Etiology Although exact mechanisms causing AMN have yet to be elucidated, there is evidence to suggest that vascular compromise of the deep retinal capillary plexus of the retina leads to the vision loss seen in patients with this disease.[3] [5] Another [eyewiki.aao.org]

The condition appears to mainly affect young women, and in this group there is a high incidence of a recent immunologic disturbance suggesting an immune-based etiology. [aaojournal.org]

Oral contraceptive pills Hypotension/shock due to several causes (post-partum, post-surgery, trauma etc) Intravenous contrast Intravenous ephedrine/epinephrine Caffeine Pro-thrombin associated antiphospholipid antibodies Pre-eclampsia Sinus infection Pathophysiology [eyewiki.aao.org]