A Case of Acute Macular Neuroretinopathy in a Young Male.

Kim, Su Jin; Park, Young Min; Cho, Hyun Kyung; Huh, Hyoun Do; Park, Jong Moon

doi:2017.58.6.751

J Korean Ophthalmol Soc > Volume 58(6); 2017 > Article

Case Report

Journal of the Korean Ophthalmological Society 2017;58(6):751-755.
DOI: https://doi.org/10.3341/jkos.2017.58.6.751 Published online June 15, 2017.

A Case of Acute Macular Neuroretinopathy in a Young Male.

Su Jin Kim, Young Min Park, Hyun Kyung Cho, Hyoun Do Huh, Jong Moon Park

¹Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea. parkjm@gnu.ac.kr
²Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea.

젊은 남자에서 발생한 급성 황반 신경망막병증 1예

김수진^1,2⋅박영민^1,2⋅조현경^1,2⋅허현도^1,2⋅박종문^1,2

경상대학교 의과대학 안과학교실¹, 창원경상대학교병원 안과²

Correspondence: Jong Moon Park,
Email: parkjm@gnu.ac.kr

Received: 20 October 2016 • Revised: 31 March 2017 • Accepted: 20 May 2017

Abstract

PURPOSE
We report a rare case of unilateral acute macular neuroretinoapthy in a young male. CASE SUMMARY: A 35-year-old male presented with a 2-day history of paracentral scotoma. He had suffered for 2 days from a flu-like illness, and his best corrected visual acuity was 20/20 OD and 20/20 OS. Pupillary reflex was normal and no relative afferent pupillary defects were not found. Ocular movement test was normal and pain on ocular movement was not noticed. Ophthalmoscopic examination of the left eye revealed multiple exudates lining the nasal macula toward the fovea. A Humphrey visual field study identified small paracentral scotoma. Spectral domain optical coherence tomography (SD-OCT, Heidelberg Engineering, Heidelberg, Germany) of the lesions showed a hyper-reflective lesion located in the outer plexiform layer and inflammatory cell infiltration. Fluorescent angiography was normal in the macula but showed late leak at the disc. The multifocal electroretinogram (mfERG) showed decreased foveal P1 amplitude in the left eye. The patient was diagnosed with acute macular neuroretinopathy and was treated with 60 mg of prednisolone. His subjective symptoms were improved, the paracentral scotoma disappeared, and the lesions appeared different upon SD-OCT; specifically, the hyper-reflective lesion disappeared and the outer plexiform layer showed thinning. CONCLUSIONS: Acute macular neuroretinopathy is a rare disease, and we report a case using SD-OCT and mfERG.

Key Words: Acute macular neuroretinopathy;Multifocal electroretinogram (mfERG);Spectral domain optical coherence tomography (SD-OCT)