A Case of Acute Macular Neuroretinopathy after Non-ocular Trauma

ABSTRACT

PURPOSE: In the present study, an unusual case of traumatic retinopathy presenting as acute macular neuroretinopathy was reported. CASE SUMMARY: A 69-year-old male was involved in a car accident and experienced a left 5th rib fracture. There was no direct ocular trauma. However, after the accident he noticed paracentral scotoma and loss of vision in his left eye. At initial examination 4 days after the trauma, central visual acuity was hand motion and visual field test revealed central scotoma in the left eye. Spectral domain optical coherence tomography showed hyper-reflectivity of the outer nuclear layer and disruption of the ellipsoid zone. Fluorescein angiography did not show any leakage or vascular damage but near-infrared autofluorescence imaging showed a dark lesion in the macular area. Visual acuity was improved to 0.2 at 2 weeks after trauma and 0.6 at 6 months after trauma while mild ellipsoid zone defect and visual field defect persisted. CONCLUSIONS: Traumatic retinopathy presenting as acute macular neuroretinopathy is an uncommon disease causing paracentral scotomas after non-ocular trauma, and to the best of our knowledge, this is the first reported case in Korea.