Audo Isabelle, Gocho Kiyoko, Rossant Florence, Mohand-Saïd Saddek, Loquin Kevin, Bloch Isabelle, Sahel José-Alain, Paques Michel
Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU View Maintain, INSERM-DHOS CIC 1423, Paris, 75012, France.
INSERM, U968, Paris, 75012, France.
Graefes Arch Clin Exp Ophthalmol. 2016 May;254(5):855-64. doi: 10.1007/s00417-015-3136-6. Epub 2015 Sep 7.
To report functional and high-resolution retinal imaging abnormalities, including adaptive optics (AO) throughout the course of acute macular neuroretinopathy (AMNR).
Two female patients (four eyes) with a diagnosis of AMNR were observed at the Clinical Investigation Center, CHNO des Quinze-Vingts, Paris, France. The patients underwent detailed ophthalmic examination including best-corrected visual acuity, slit-lamp examination, kinetic and static perimetry, full-field and multifocal electroretinogram, infrared reflectance, autofluorescence imaging and spectral-domain optical coherence tomography (SD-OCT) and AO fundus imaging at presentation and during follow-up.
Both cases showed concomitant loss of integrity of the outer retinal structures on SD-OCT, and marked abnormalities on AO imaging with disruption of the visibility of the cone mosaic. In the first case, photoreceptor damage was seen to progress during several weeks before healing. In both cases, there were persistent morphological abnormalities of photoreceptors 1 year after onset.
This study further highlights the value of AO fundus imaging to facilitate detection, mapping, and monitoring of damage to the cone outer segments during AMNR. In particular, residual damage to the cone mosaic can be precisely documented.
报告急性黄斑神经视网膜病变（AMNR）整个病程中的功能和高分辨率视网膜成像异常情况，包括自适应光学（AO）成像。
在法国巴黎国立眼科中心（CHNO des Quinze-Vingts）临床研究中心观察了两名诊断为AMNR的女性患者（四只眼）。患者在就诊时及随访期间接受了详细的眼科检查，包括最佳矫正视力、裂隙灯检查、动态和静态视野检查、全视野和多焦视网膜电图、红外反射、自发荧光成像、光谱域光学相干断层扫描（SD-OCT）以及AO眼底成像。
两例患者在SD-OCT上均显示视网膜外层结构完整性同时丧失，AO成像有明显异常，视锥细胞镶嵌的可见性遭到破坏。在第一例中，在愈合前数周可见光感受器损伤进展。两例患者在发病1年后光感受器均存在持续的形态学异常。
本研究进一步强调了AO眼底成像在AMNR期间促进视锥细胞外段损伤的检测、定位和监测方面的价值。特别是，可以精确记录视锥细胞镶嵌的残余损伤。
