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International Ophthalmology

, Volume 38, Issue 6, pp 2403–2416 | Cite as

Classification and characterization of acute macular neuroretinopathy with spectral domain optical coherence tomography

  • Katerina Hufendiek
  • Maria-Andreea Gamulescu
  • Karsten Hufendiek
  • Horst Helbig
  • David Märker
Original Paper
  • 263 Downloads

Abstract

Purpose

To classify and characterize AMN lesions with SD-OCT during a follow-up as long as 5 years.

Methods

Retrospective study of 14 patients (18 eyes) with special focus on SD-OCT. We measured thickness of inner nuclear layer (INL), outer retinal layer (ONL), and hyperreflective band at baseline and during follow-up. AMN lesions were classified as type 1 and type 2.

Results

Of 14 patients (six males, eight females, mean age 29.7 years), three patients (four eyes) had type 1 and nine (12 eyes) had type 2. Two patients did not meet the criteria for AMN type 1 or 2 and were therefore classified as new subtype of AMN. In all patients, statistically significant thinning of ONL and INL was observable. Mean ONL of all patients was 90.2 ± 7.81 and 72.3 ± 15.64 μm (p < 0.05) during follow-up; mean INL was 54.4 ± 10.71 and 37.5 ± 6.18 μm (p < 0.05) in the course. In the subgroup analysis in AMN type 2, the thinning of both ONL and INL was also statistically significant (mean ONL: 87.4 ± 6.02 and 71.6 ± 12.7 μm (p < 0.05); mean INL: 48.5 ± 5.04 and 38.5 ± 5.6 μm (p < 0.05)) in the course.

Conclusion

SD-OCT allows for classification, characterization, and further understanding of AMN lesions. Up to now, this is one of the largest AMN case series differentiating into different subtypes and following up for up to 5 years. Furthermore, we describe a new AMN subtype characterized by initially clinically visible yellowish parafoveal lesions, subtle pigmentary changes at late stage, lack of classic dark appearance on IR reflectance, involvement of RPE/Bruch’s complex, and disruption of ellipsoid zone and interdigitation zone. The patients suffered from a prolonged visual impairment and paracentral scotomata. We propose the term AMN type 3 or “paracentral acute outer maculopathy.”

Keywords

AMN Classification Characterization SD-OCT Follow-up 

Notes

Compliance with ethical standards

Conflict of interest

No conflicts of interest to declare.

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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Katerina Hufendiek
    • 1
    • 2
  • Maria-Andreea Gamulescu
    • 1
  • Karsten Hufendiek
    • 1
    • 2
  • Horst Helbig
    • 1
  • David Märker
    • 1
  1. 1.Department of OphthalmologyUniversity Medical Center RegensburgRegensburgGermany
  2. 2.University Eye HospitalHannover Medical SchoolHannoverGermany

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