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Photo Essay
January 1998

Acute Macular Neuroretinopathy

Arch Ophthalmol. 1998;116(1):112-113. doi:10.1001/archopht.116.1.112

A 40-YEAR-OLD woman complained of a sudden onset of swirling central scotomas that appeared dark against a light background and light against a dark background. She had an episode of viral bronchitis 1 week earlier and had been taking oral contraceptives for several years.

The corrected visual acuity was 20/20 OU. There were paracentral scotomas that were denser temporally in both eyes and worse in the right eye (Figure 1). Direct ophthalmoscopy revealed bilateral reddish-brown areas in the macular area (Figure 2). These lesions could not be seen with indirect ophthalmoscopy but were visible with a 90-diopter lens. The results of fluorescein angiography were normal (Figure 3). Red-free frames highlighted the macular lesions (Figure 4). Indocyanine green angiography revealed no abnormalities.

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