Analysis the clinical characteristics of unilateral acute idiopathic maculopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Yang Weidan , Min Jingyu , Xie Liping ,  Gong Yuanyuan

Department of Ophthalmology, Shanghai First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, China (Yang Weidan is now in Department of Ophthalmology, Tongzhou People Hospital);

Corresponding author：

Gong Yuanyuan, Email: gyydr@126.com

Keywords：

Macula lutea/injuries; Retinal Diseases/diagnosis; Disease attributes

DOI：

10.3760/cma.j.issn.1005-1015.2017.06.004

Video：

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Objective To observe the clinical characteristics and fundus imaging features of unilateral acute idiopathic maculopathy (UAIM). Methods Retrospective cases series. Six eyes of 6 patients with UAIM were included in this study. There were 4 males and 2 females. All patients underwent best corrected visual acuity (BCVA), fundus color photography, spectral domain optical coherence tomography (SD-OCT) and fundus fluorescein angiography (FFA) examinations. 3 patients underwent indocyanine green angiography (ICGA) examination. No intervention was given in all patients after diagnosis. The mean follow-up was 6.3 months. BCVA, fundus color photography, SD-OCT and FFA were performed in follow-up. Results The ocular symptoms included unilateral sudden decreased vision, metamorphopsia and central scotoma. All patients had a yellow-white lesion involving the macular and irregular small bleeding was seen in 3 eyes. Irregular hyper-fluorescence in macular area was seen in all patients, some with the hemorrhages showed blocked fluorescence at the early stage of FFA and fluorescence storage at the late stage. ICGA showed that hypo-fluorescence in macular area continually. SD-OCT showed that subretinal fluid in the macular and lost the ellipsoid zone. During the follow-up period, the subretinal fluid was absorbed spontaneously in one month. The ellipsoid zone structure recovered gradually and the visual acuity were normal. At the time of the latest follow-up, the BCVA was 0.8 in 4 eyes, 1.0 in 2 eyes. Conclusions UAIM is featured with a unilateral, acute, transient and exudative lesion in the macular, which can be spontaneously resolved; It mainly affects outer retina.

Citation： Yang Weidan, Min Jingyu, Xie Liping, Gong Yuanyuan. Analysis the clinical characteristics of unilateral acute idiopathic maculopathy. Chinese Journal of Ocular Fundus Diseases, 2017, 33(6): 573-576. doi: 10.3760/cma.j.issn.1005-1015.2017.06.004 Copy

1.	Yannuzzi LA, Jampol LM, Rabb MF, et al. Unilateral acute idiopathic maculopathy[J]. Arch Ophthalmol, 1991, 109(10): 1411-1416. DOI:10.1001/archopht.1991.01080100091049.
2.	杜磊, 邢怡桥, 陈长征.急性特发性黄斑病变[J]. 中国实用眼科杂志, 2006, 24(5): 450-452. DOI:10.3760/cma.j.issn.1006-4443.2006.05.002.Du L, Xing YQ, Chen CZ. Acute idiopathic maculopathy[J]. Chin J Pract Ophthalmol, 2006, 24(5): 450-452. DOI: 10.3760/cma.j.issn.1006-4443.2006.05.002.
3.	Hoang QV, Strauss DS, Pappas A, et al. Imaging in the diagnosis and management of acute idiopathic maculopathy[J]. Int Ophthalmol Clin, 2012, 52(4): 263-268. DOI:10.1097/IIO.0b013e31826861db.
4.	Ng SK, Ebneter A, Gilhotra JS.Atypical findings in delayed presentation of unilateral acute idiopathic maculopathy[J]. Int Ophthalmol, 2013, 33(4): 387-389. DOI:10.1007/s10792-013-9722-x.
5.	Beck AP, Jampol LM, Glaser DA, et al. Is coxsackievirus the cause of unilateral acute idiopathic maculopathy?[J]. Arch Ophthalmol, 2004, 122(1): 121-123.DOI:10.1001/archopht.122.1.121.
6.	Jung CS, Payne JF, Bergstrom CS, et al. Multimodality diagnostic imaging in unilateral acute idiopathic maculopathy[J]. Arch Ophthalmol, 2012, 130(1): 50-56. DOI: 10.1001/archophthalmol.2011.359.
7.	Hashimoto Y, Saito W, Saito M, et al. Increased choroidal blood flow velocity with regression of unilateral acute idiopathic maculopathy[J]. Jpn J Ophthalmol, 2015, 59(4): 252-260. DOI: 10.1007/s10384-015-0380-6.
8.	Landa G, Su E, Garcia PM, et al. Inner segment-outer segment junctional layer integrity and corresponding retinal sensitivity in dry and wet forms of age-related macular degeneration[J]. Retina, 2011, 3l(1): 364-370. DOI:10.1097/IAE.0b013e3181e91132.
9.	de la Fuente MA, Cuadrado R.Unilateral acute idiopathic maculopathy: angiography, optical coherence tomography and microperimetry findings[J]. J Ophthalmic Inflamm Infect, 2011, 1(3): 125-127. DOI:10.1007/s12348-010-0014-6.
10.	Aggio FB, Farah ME, Meirelles RL, et al. STRATUSOCT and multifocal ERG in unilateral acute idiopathic maculopathy[J]. Graefe’s Arch Clin Exp Ophthalmol, 2006, 244(4): 510-516.DOI: 10.1007/s00417-005-1172-3.
11.	杨卫丹, 俞素勤, 王泓, 等. 不同病程梅毒性后葡萄膜炎患眼眼底影像特征观察[J]. 中华眼底病杂志, 2017, 33(1): 31-34.DOI:10.3760/cma.j.issn.1005-1015.2017.01.009.Yang WD, Yu SQ, Wang H, et al. Multimodal fundus imaging in patients of syphilitic posterior uveitis at different stages[J]. Chin J Ocul Fundus Dis, 2017, 33(1): 31-34. DOI:10.3760/cma.j.issn.1005-1015.2017.01.009.
12.	Schneider U, Inhoffen W, Gelisken F. Indocyanine green angiography in a case of unilateral recurrent posterior acute multifocal placoid pigment epitheliopathy[J]. Acta Ophthalmol Scand, 2003, 81(1): 72-75. DOI: 10.1034/j.1600-0420.2003.00026.x.
13.	Gaudric A, Mrejen S. Why the dots are black only in the late phase of the indocyanine green angiography in multiple evanescent white dot syndrome[J]. Retin Cases Brief Rep, 2017, 11 Suppl 1: S81-85. DOI: 10.1097/ICB.0000000000000422.
14.	Iaccheri E, Fiore T, Androudi S, et al. Acute posterior multifocal placoid pigment epitheliopathy (APMPPE): final outcome and visual prognosis[J]. IOVS, 2004, 45: 2692-2697.
15.	Singh AK, Sharma V. A rare case of unilateral acute idiopathic maculopathy in young male [J]. J Clin Diagn Res, 2017, 11(2): 3-4. DOI: 10.7860/JCDR/2017/24197.9443.

1. Yannuzzi LA, Jampol LM, Rabb MF, et al. Unilateral acute idiopathic maculopathy[J]. Arch Ophthalmol, 1991, 109(10): 1411-1416. DOI:10.1001/archopht.1991.01080100091049.
2. 杜磊, 邢怡桥, 陈长征.急性特发性黄斑病变[J]. 中国实用眼科杂志, 2006, 24(5): 450-452. DOI:10.3760/cma.j.issn.1006-4443.2006.05.002.Du L, Xing YQ, Chen CZ. Acute idiopathic maculopathy[J]. Chin J Pract Ophthalmol, 2006, 24(5): 450-452. DOI: 10.3760/cma.j.issn.1006-4443.2006.05.002.
3. Hoang QV, Strauss DS, Pappas A, et al. Imaging in the diagnosis and management of acute idiopathic maculopathy[J]. Int Ophthalmol Clin, 2012, 52(4): 263-268. DOI:10.1097/IIO.0b013e31826861db.
4. Ng SK, Ebneter A, Gilhotra JS.Atypical findings in delayed presentation of unilateral acute idiopathic maculopathy[J]. Int Ophthalmol, 2013, 33(4): 387-389. DOI:10.1007/s10792-013-9722-x.
5. Beck AP, Jampol LM, Glaser DA, et al. Is coxsackievirus the cause of unilateral acute idiopathic maculopathy?[J]. Arch Ophthalmol, 2004, 122(1): 121-123.DOI:10.1001/archopht.122.1.121.
6. Jung CS, Payne JF, Bergstrom CS, et al. Multimodality diagnostic imaging in unilateral acute idiopathic maculopathy[J]. Arch Ophthalmol, 2012, 130(1): 50-56. DOI: 10.1001/archophthalmol.2011.359.
7. Hashimoto Y, Saito W, Saito M, et al. Increased choroidal blood flow velocity with regression of unilateral acute idiopathic maculopathy[J]. Jpn J Ophthalmol, 2015, 59(4): 252-260. DOI: 10.1007/s10384-015-0380-6.
8. Landa G, Su E, Garcia PM, et al. Inner segment-outer segment junctional layer integrity and corresponding retinal sensitivity in dry and wet forms of age-related macular degeneration[J]. Retina, 2011, 3l(1): 364-370. DOI:10.1097/IAE.0b013e3181e91132.
9. de la Fuente MA, Cuadrado R.Unilateral acute idiopathic maculopathy: angiography, optical coherence tomography and microperimetry findings[J]. J Ophthalmic Inflamm Infect, 2011, 1(3): 125-127. DOI:10.1007/s12348-010-0014-6.
10. Aggio FB, Farah ME, Meirelles RL, et al. STRATUSOCT and multifocal ERG in unilateral acute idiopathic maculopathy[J]. Graefe’s Arch Clin Exp Ophthalmol, 2006, 244(4): 510-516.DOI: 10.1007/s00417-005-1172-3.
11. 杨卫丹, 俞素勤, 王泓, 等. 不同病程梅毒性后葡萄膜炎患眼眼底影像特征观察[J]. 中华眼底病杂志, 2017, 33(1): 31-34.DOI:10.3760/cma.j.issn.1005-1015.2017.01.009.Yang WD, Yu SQ, Wang H, et al. Multimodal fundus imaging in patients of syphilitic posterior uveitis at different stages[J]. Chin J Ocul Fundus Dis, 2017, 33(1): 31-34. DOI:10.3760/cma.j.issn.1005-1015.2017.01.009.
12. Schneider U, Inhoffen W, Gelisken F. Indocyanine green angiography in a case of unilateral recurrent posterior acute multifocal placoid pigment epitheliopathy[J]. Acta Ophthalmol Scand, 2003, 81(1): 72-75. DOI: 10.1034/j.1600-0420.2003.00026.x.
13. Gaudric A, Mrejen S. Why the dots are black only in the late phase of the indocyanine green angiography in multiple evanescent white dot syndrome[J]. Retin Cases Brief Rep, 2017, 11 Suppl 1: S81-85. DOI: 10.1097/ICB.0000000000000422.
14. Iaccheri E, Fiore T, Androudi S, et al. Acute posterior multifocal placoid pigment epitheliopathy (APMPPE): final outcome and visual prognosis[J]. IOVS, 2004, 45: 2692-2697.
15. Singh AK, Sharma V. A rare case of unilateral acute idiopathic maculopathy in young male [J]. J Clin Diagn Res, 2017, 11(2): 3-4. DOI: 10.7860/JCDR/2017/24197.9443.

Chinese Journal of Ocular Fundus Diseases

Analysis the clinical characteristics of unilateral acute idiopathic maculopathy

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