June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Adaptive Optics OCT Imaging in Type 2 Acute Macular Neuroretinopathy
Author Affiliations & Notes
  • Nathan Doble
    The Ohio State University, Columbus, Ohio, United States
  • Elaine Wells-Gray
    Lumata Health, Oklahoma, United States
  • Matthew Ohr
    The Ohio State University, Columbus, Ohio, United States
  • Stacey Choi
    The Ohio State University, Columbus, Ohio, United States
  • Footnotes
    Commercial Relationships   Nathan Doble None; Elaine Wells-Gray None; Matthew Ohr None; Stacey Choi None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1051. doi:
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      Nathan Doble, Elaine Wells-Gray, Matthew Ohr, Stacey Choi; Adaptive Optics OCT Imaging in Type 2 Acute Macular Neuroretinopathy. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1051.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Acute macular neuroretinopathy (AMN) is a rare retinal condition first described in 1975. Here, an adaptive-optics-optical-coherence-tomography-scanning-laser-ophthalmoscope (AO-OCT-SLO) was used to study the integrity of the outer retina within the lesion area as well as the surrounding tissue in type 2 AMN.

Methods : A 35-year-old Caucasian female complaining of a unilateral blind spot was imaged using various retinal imaging modalities including clinical OCT, OCT-angiography, fundus fluorescein angiography and AO imaging. An AO-SLO en-face montage was acquired that covered the entire lesion area, along with the simultaneous AO-OCT B-scans.

Results : Fundus examination revealed multiple paracentral reddish-brown petaloid lesions in the symptomatic left eye, while the other eye was unremarkable. The clinical OCT images showed areas of hyper-reflectance at the outer plexiform layer / outer nuclear layer complex with a disrupted inner /outer segment junction, which are characteristic features of type 2 AMN. AO imaging further revealed either shortening or absence of cone outer segments within the AMN lesions attributing to the darker features observed in the en-face images from fundus photography and scanning laser ophthalmoscopy.
The figure shows AO-OCT B-scans from three retinal locations: (A) At 4° nasal (N) / 1° inferior (I) - the retina is not affected by AMN, hence all the outer retinal layers (inner / outer segment junction (IS/OS) and cone outer segment tip (COST) layers) are distinct and regular. (B) 2.5° N retina - this is a transition zone, where left half of the scan has distinct IS/OS junction and COST layer, but the right half of the scan (indicated by white asterisks) shows blurred IS/OS junction and the absence of the COST layer. (C) 2.5° N / 1° I - this location is inside the lesion where the IS/OS junction and the COST layer become indistinct and absent respectively. Furthermore, the OS shortens and eventually the COST layer become absent leading to the collapse of the OS in the central portion of the B-scan. ILM – inner limiting membrane, RPE – retinal pigment epithelium, BrM – Bruch’s membrane, RNFL – retinal nerve fiber layer, GCL – ganglion cell layer, IPL – inner plexiform layer, INL – inner nuclear layer.

Conclusions : The AO findings indicate that the petaloid lesions in type 2 AMN are caused by a combination of the shortening and absence of the outer segments in individual cone photoreceptors.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

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