Microvascular change in acute macular neuroretinopathy by using optical coherence tomography angiography

A 27-year-old pregnant female underwent cesarean section due to preeclampsia. Two days after the delivery, she presented with acute onset of blurred vision in the left eye. Optical coherence tomography (OCT) revealed characteristic findings of acute macular neuroretinopathy (AMN) in both eyes. During the follow-up, her vision improved gradually, but outer nuclear layer thinning with disruption of ellipsoid zone was identified from OCT. OCT angiography was arranged and revealed both vascular defect in superficial and deep vascular plexus, which correlated with previous AMN lesions in both eyes. Subsequent microvascular change in AMN was found to involve both superficial and deep vascular plexus, which is different from the current consensus that AMN mainly involved deep vascular plexus. By using the OCT angiography, we can better visualize the detail retinal vascular structure and may identify the real mechanism in this rare retinal disorder.