Sarrasin Emérentienne, Malclès Ariane, Sarraf David
Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland.
Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Am J Ophthalmol Case Rep. 2023 Jan 5;29:101793. doi: 10.1016/j.ajoc.2023.101793. eCollection 2023 Mar.
Acute Macular Neuroretinopathy (AMN) may be the result of deep retinal capillary plexus (DCP) impairment, but its mechanism remains elusive. A recent study has described simultaneous onset of Paracentral Acute Middle Maculopathy (PAMM) and AMN, suggesting a related pathogenic pathway. In this report, we analyze and describe the imaging characteristics of patients with concomitant Central Retinal Artery Occlusion (CRAO) and AMN and suggest a mechanistic pathway to explain this relationship.
A total of 2 cases of CRAO, arteritic and non arteritic, were included in this report. At initial presentation, outer retinal layers were intact. At the two-week follow-up visit, both cases displayed Henle fiber layer hyperreflectivity and ellipsoid zone disruption consistent with AMN.
Secondary development of AMN in CRAO is a new finding. DCP ischemia secondary to CRAO may lead to Henle fiber layer disruption, leading to the characteristic findings of AMN.
急性黄斑神经视网膜病变（AMN）可能是视网膜深层毛细血管丛（DCP）受损的结果，但其机制仍不清楚。最近一项研究描述了中心旁急性黄斑病变（PAMM）和AMN同时发病，提示存在相关的致病途径。在本报告中，我们分析并描述了合并视网膜中央动脉阻塞（CRAO）和AMN患者的影像学特征，并提出一种机制来解释这种关系。
本报告纳入了2例CRAO患者，分别为动脉炎性和非动脉炎性。初次就诊时，视网膜外层完整。在两周的随访中，两例患者均表现出与AMN一致的Henle纤维层高反射性和椭圆体带破坏。
CRAO中AMN的继发发展是一项新发现。CRAO继发的DCP缺血可能导致Henle纤维层破坏，从而导致AMN的特征性表现。
