Acute Macular Neuroretinopathy AMN

Acute macular neuroretinopathy (AMN) is a rare chorioretinopathy affecting young adults mono- or bilaterally, producing disturbing symptoms of photopsia and often occurring after a flu-like illness like many of the other PIC-CPs [72]. Visual loss is variable and fundus changes are characterized by large macular orange-brown plaques (Fig. 14.7). Fluorescein an-giography shows early choroidal hypofluores-cence or can be unremarkable. The visual field can show a central scotoma. The photopsias, clinical signs and functional tests usually recover without sequels within weeks or months. AMN has been described in association with MEWDS in the same patient linking the disease to the other PICCPs [73]. The whole picture of this entity corresponds perfectly to and is characteristic of PICCPs, but the rarity of its occurrence has prevented ICGA analysis so far. We recently saw a patient examined in the early phase showing the typical fundus colour changes associated with ICGA hypofluorescence of the whole macular area, indicating choriocapillaris pathology and linking the disease to the PICCPs (Fig.14.8).

Fig. 14.7. Acute macular neuroretinopathy (AMN). Typical dark discoloration of the posterior pole
Fig. 14.8. Choriocapillaris non-perfusion in AMN. Patient presenting with visual field changes and darkened posterior pole, showing geographic hypofluo-rescence compatible with choriocapillaris non-perfu-

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