Classification and characterization of acute macular neuroretinopathy with spectral domain optical coherence tomography

Hufendiek, Katerina and Gamulescu, Maria-Andreea and Hufendiek, Karsten and Helbig, Horst and Maerker, David (2018) Classification and characterization of acute macular neuroretinopathy with spectral domain optical coherence tomography. INTERNATIONAL OPHTHALMOLOGY, 38 (6). pp. 2403-2416. ISSN 0165-5701, 1573-2630

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Abstract

PurposeTo classify and characterize AMN lesions with SD-OCT during a follow-up as long as 5years.MethodsRetrospective study of 14 patients (18 eyes) with special focus on SD-OCT. We measured thickness of inner nuclear layer (INL), outer retinal layer (ONL), and hyperreflective band at baseline and during follow-up. AMN lesions were classified as type 1 and type 2.ResultsOf 14 patients (six males, eight females, mean age 29.7years), three patients (four eyes) had type 1 and nine (12 eyes) had type 2. Two patients did not meet the criteria for AMN type 1 or 2 and were therefore classified as new subtype of AMN. In all patients, statistically significant thinning of ONL and INL was observable. Mean ONL of all patients was 90.27.81 and 72.3 +/- 15.64m (p<0.05) during follow-up; mean INL was 54.4 +/- 10.71 and 37.5 +/- 6.18m (p<0.05) in the course. In the subgroup analysis in AMN type 2, the thinning of both ONL and INL was also statistically significant (mean ONL: 87.4 +/- 6.02 and 71.6 +/- 12.7m (p<0.05); mean INL: 48.5 +/- 5.04 and 38.5 +/- 5.6m (p<0.05)) in the course.Conclusion p id=Par4 SD-OCT allows for classification, characterization, and further understanding of AMN lesions. Up to now, this is one of the largest AMN case series differentiating into different subtypes and following up for up to 5years. Furthermore, we describe a new AMN subtype characterized by initially clinically visible yellowish parafoveal lesions, subtle pigmentary changes at late stage, lack of classic dark appearance on IR reflectance, involvement of RPE/Bruch's complex, and disruption of ellipsoid zone and interdigitation zone. The patients suffered from a prolonged visual impairment and paracentral scotomata. We propose the term AMN type 3 or paracentral acute outer maculopathy.

Item Type: Article
Uncontrolled Keywords: ACUTE MIDDLE MACULOPATHY; AUTOFLUORESCENCE; LOCALIZATION; REFLECTANCE; AMN; Classification; Characterization; SD-OCT; Follow-up
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Augenheilkunde
Depositing User: Dr. Gernot Deinzer
Date Deposited: 04 Oct 2019 10:24
Last Modified: 04 Oct 2019 10:24
URI: https://pred.uni-regensburg.de/id/eprint/13447

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