Acute macular neuroretinopathy associated with influenza vaccination with decreased flow at the deep capillary plexus on OCT angiography

Liu, Jeffrey; Nesper, Peter L.; Fawzi, Amani A.; Gill, Manjot K.

doi:10.1016/j.ajoc.2018.02.008

Cited by 45 publications

(45 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, Liu et al [20] described a case of a middle age woman with OCT features similar to the one we found, but that patient underwent an influenza vaccination and was affected by Raynaud disease, in contrast to our young patient. On the other hand, Introini et al suggested an association between the AMN and the intranasal cocaine use in a 24-year-old woman.…”

Section: Discussionsupporting

confidence: 66%

“…The etiology is still unknown [1]. To date, over 100 cases of AMN have been published and Bhavsar et al in a review reported that 47.5% of described cases were associated with a non-specific flu-like illness or fever [2], but to date a strong link with the influenza virus has not been yet demonstrated [20]. One documented association was with the dengue fever [11,21].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral Acute Macular Neuroretinopathy in a Young Patient: Imaging and Visual Field during Two-Year-Follow-Up

Porta¹,

Tripodi

Toro

et al. 2020

Diagnostics

View full text Add to dashboard Cite

Acute macular neuroretinopathy (AMN) is a rare disorder. We report a case of bilateral AMN in a young female patient, without any risk factors. She referred a positive scotoma in both eyes after flu-like symptoms. Fundus examination revealed parafoveal dark-reddish oval lesions in both eyes. Therefore, we performed visual field, optical coherence tomography (OCT), fluorescein angiography (FA) and indocyanine green angiography (ICG) at baseline and several times during the two years of follow-up. The infrared (IR) imaging showed one rounded hyporeflective lesion in the left eye and two similar lesions in the right eye. The OCT demonstrated the characteristic alterations in the outer retina. The visual field also demonstrated scotomas corresponding with these lesions. The OCT and IR features disappeared at the end of the follow-up except for the left eye, which continued to have hyperreflective spots in the outer plexiform layer. The patient complained about a residual scotoma only in the left eye after two years. Our case shows a difference in disease progression in the two eyes of the same patient, suggesting that several mechanisms can be implicated in the pathology of AMN.

show abstract

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Bilateral Acute Macular Neuroretinopathy in a Young Patient: Imaging and Visual Field during Two-Year-Follow-Up

Porta¹,

Tripodi

Toro

et al. 2020

Diagnostics

View full text Add to dashboard Cite

show abstract

“…We applied a projection-resolved (PR-OCTA) algorithm in postprocessing to reduce projection artifacts from superficial vessels projected onto the deeper capillary layers and to reduce projection artifacts within hyperreflective lesions. We implemented a version of the PR-OCTA algorithm developed by Zhang et al 12 , 16 , 17 These authors noted that projection tail artifacts in OCTA have lower decorrelation values compared to real vessels. 17 , 20 Taking advantage of this observation, the algorithm searches each A-scan for successive, high-valued peaks, which correspond to real vessels.…”

Section: Methodsmentioning

confidence: 99%

“…PAMM has been associated with reduced blood flow of the SCP and DCP, 2 MCP alone, 7 or MCP and DCP. 1 , 5 , 9 – 11 Similarly, AMN has been associated with occlusion of the DCP 4 , 12 or choriocapillaris. 13 , 14 The two major confounding factors in all these studies are projection artifacts cast from superficial blood vessels onto the deeper layers, and artifactual OCT signal attenuation underneath INL/ONL hyperreflective lesions.…”

mentioning

confidence: 99%

“…In order to better delineate the capillary plexuses and to overcome these challenges, we used a version of projection-resolved (PR)-OCTA, an algorithm developed by Zhang et al, 16 which reduces the projection artifacts while preserving the continuity of the middle and deep capillaries. 12 , 17 The goal of our study was to employ PR-OCTA to elucidate the capillary plexus/es involved in AMN and PAMM. In a subcohort of eyes that underwent repeat OCTA imaging during follow-up, we also explored the potential correlations between capillary reperfusion on OCTA and structural integrity of the relevant retinal layers on OCT in PAMM and AMN.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Projection-Resolved OCT Angiography of Microvascular Changes in Paracentral Acute Middle Maculopathy and Acute Macular Neuroretinopathy

Chu

Nesper

Soetikno

et al. 2018

Invest. Ophthalmol. Vis. Sci.

Self Cite

View full text Add to dashboard Cite

PurposeTo identify the microvascular changes associated with paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) and to improve our understanding of the relevant involvement of the three retinal capillary plexuses using projection-resolved optical coherence tomography angiography (PR-OCTA).MethodsThis was a retrospective study of 18 eyes with AMN or PAMM imaged with OCTA. We used cross-sectional PR-OCTA to localize reduced flow signal to the superficial (SCP), middle (MCP), or deep capillary plexus (DCP) or choriocapillaris that corresponded to inner retinal PAMM or outer retinal AMN lesions on OCT.ResultsFive eyes with AMN showed outer retinal disruption on OCT associated with reduced DCP flow signal. All three eyes with AMN and follow-up had recovery of DCP flow. Thirteen eyes with PAMM showed middle retinal disruption on OCT associated with reduced flow signal in both the MCP and DCP. Of these, five also had reduced flow signal in the SCP. All 10 eyes with PAMM and follow-up showed variable recovery of flow signal in one or more plexuses. PAMM reperfusion was primarily arterial in nature. Three eyes with PAMM and no evidence of MCP reperfusion experienced severe thinning of the inner nuclear layer (INL), while seven eyes with robust MCP flow signal recovery showed relative preservation of INL thickness.ConclusionsUsing PR-OCTA, we found that AMN was associated with reduced DCP flow signal, while PAMM was associated with reduced MCP and DCP flow signal and occasionally the SCP. The MCP appears to be important in sustaining INL thickness in these eyes.

show abstract

Association of Ocular Adverse Events With Inactivated COVID-19 Vaccination in Patients in Abu Dhabi

et al. 2021

View full text Add to dashboard Cite

s of March 2021, the COVID-19 pandemic has caused 35 million infections and more than 1 million deaths worldwide, leading to the urgent demand for a vaccine. 1 To date, 2 inactivated vaccine candidates have been reported to protect against SARS-CoV-2. The inactivated COVID-19 vaccine by Sinopharm's China National Biotec Group is mixed with aluminum-based adjuvant and has been found tolerable and immunogenic in healthy people with 2 doses administered 21 days apart. 2 As of March 2021, the United Arab Emirates Ministry of Health and Prevention announced that the United Arab Emirates had crossed 2 million doses of the Sinopharm inactivated vaccine (20% of the population). We hereby present a case series of ocular adverse events presenting at Cleveland Clinic Abu Dhabi in the United Arab Emirates after receiving the Sinopharm COVID-19 vaccine. MethodsRetrospective consecutive case series, adherent to the reporting guidelines, 3 of patients presenting at the retina and uveitis service from September 2020 to January 2021 were performed in accordance with the ethical standards of the Declaration of Helsinki. 4 The institutional review board of Cleveland Clinic Abu Dhabi waived the need for approval of a case series of fewer than 10 patients. Written informed consent was obtained from all enrolled individuals.The main inclusion criterion was the development of ocular symptoms within 15 days from the first dose of the COVID-19 vaccine. Each patient underwent Snellen best-corrected visual acuity (BCVA) that was then converted to logMAR and IMPORTANCE As vaccinations against COVID-19 continue, potential ocular adverse events should be reported in detail to increase awareness among the medical community, although typically, a causal relationship cannot be established definitively.OBJECTIVE To describe ocular adverse events that occur soon after receiving an inactivated COVID-19 vaccination (Sinopharm). DESIGN, SETTING, AND PARTICIPANTSThis case series took place from September 2020 to January 2021 at Cleveland Clinic Abu Dhabi, a tertiary referral center. Patients who reported ocular adverse events and presented within 15 days from the first of 2 doses of an inactivated COVID-19 vaccine were analyzed. MAIN OUTCOMES AND MEASURESEach patient underwent Snellen best-corrected visual acuity that was then converted to logMAR, applanation tonometry, and biomicroscopic examination with indirect ophthalmoscopy. Color fundus photography was obtained with a conventional 9-field fundus photography camera or with a widefield fundus photography system. Optical coherence tomography and optical coherence tomographic angiography images were obtained. Sex, race, age, and clinical data were self-reported.RESULTS Nine eyes of 7 patients (3 male individuals) presenting with ocular complaints following COVID-19 vaccine were included in the study. The mean (SD) age was 41.4 (9.3) years (range, 30-55 years); the mean best-corrected visual acuity was 0.23 logMAR (range, 0-1 logMAR; approximate Snellen equivalent, 20/32). The mean time of ocular adv...

show abstract

Acute macular neuroretinopathy associated with influenza vaccination with decreased flow at the deep capillary plexus on OCT angiography

Cited by 45 publications

References 25 publications

Bilateral Acute Macular Neuroretinopathy in a Young Patient: Imaging and Visual Field during Two-Year-Follow-Up

Bilateral Acute Macular Neuroretinopathy in a Young Patient: Imaging and Visual Field during Two-Year-Follow-Up

Projection-Resolved OCT Angiography of Microvascular Changes in Paracentral Acute Middle Maculopathy and Acute Macular Neuroretinopathy

Association of Ocular Adverse Events With Inactivated COVID-19 Vaccination in Patients in Abu Dhabi

Contact Info

Product

Resources

About