A 23-YEAR-OLD white woman had a 7-day history of bilateral central visual disturbance. Three weeks prior to her visual symptoms, she had a flu-like illness. Her only medication was an oral contraceptive. Her unaided visual acuity was 20/20 (N5) OD and 20/17 (N5) OS. Fundus examination revealed bilateral red wedge-shaped lesions centered around the fovea, consistent with acute macular neuroretinopathy. Although classically, these lesions photograph poorly, they were shown clearly with the scanning laser ophthalmoscope (Figure 1). Bilateral paracentral scotomata were demonstrated by Humphrey 10-2 static visual field testing (Zeiss, Welwyn Garden City, England)(Figure 2). Results of standardized electroretinography (ERG), electro-oculography, and pattern ERG were normal according to the guidelines of the International Society for Clinical Electrophysiology of Vision. Multifocal ERG, using the VERIS system (EDI Inc, San Mateo, Calif), showed areas of reduced function in both eyes, corresponding to areas of visual field loss (Figure 3).
Browning AC, Gupta R, Barber C, Lim CS, Amoaku WM. The Multifocal Electroretinogram in Acute Macular Neuroretinopathy. Arch Ophthalmol. 2003;121(10):1506-1507. doi:10.1001/archopht.121.10.1506