Gillies M, Sarks J, Dunlop C, Mitchell P
Department of Ophthalmology, Sydney University, New South Wales, Australia.
Aust N Z J Ophthalmol. 1997 Aug;25(3):207-10. doi: 10.1111/j.1442-9071.1997.tb01393.x.
Acute macular neuroretinopathy (AMNR) is an uncommon disease of uncertain aetiology. We report on four males who developed unilateral changes following trauma which closely resembled acute macular retinopathy.
Retrospective review of selected cases.
Four male patients developed a central or paracentral scotoma immediately or soon after an accident in which they suffered moderately severe bodily injury without direct ocular trauma. Vision was reduced in three patients. All four patients had characteristic well-circumscribed, dark macular lesions best seen using red-free light. The lesions cleared slowly in the two cases who returned for review.
A picture that closely resembles AMNR may be seen after trauma. The mechanism may involve a sudden rise in ocular venous pressure. This may be an unrecognized cause of visual loss after non-ocular trauma which may be regarded as functional. The subtle retinal lesions may be overlooked unless the fundi are examined in red-free light and the macular dark areas are compared.
急性黄斑神经视网膜病变(AMNR)是一种病因不明的罕见疾病。我们报告了四名男性患者,他们在遭受外伤后出现单侧病变,与急性黄斑视网膜病变极为相似。
对选定病例进行回顾性研究。
四名男性患者在遭受中度严重身体损伤但无直接眼部外伤的事故后立即或不久后出现中心或旁中心暗点。三名患者视力下降。所有四名患者均有特征性的边界清晰的黄斑暗病变,在无赤光下观察最佳。在复诊的两例患者中,病变缓慢消退。
外伤后可能出现与AMNR极为相似的表现。其机制可能涉及眼静脉压突然升高。这可能是未被认识的非眼部外伤后视力丧失的原因,这种视力丧失可能被视为功能性的。除非在无赤光下检查眼底并比较黄斑暗区,否则细微的视网膜病变可能被忽视。