title: A patient with acute macular neuroretinopathy and central retinal vein occlusion.
abstract: OBJECTIVE
  The precise mechanism causing acute macular neuroretinopathy (AMN) is still unknown. A recent report suggested that choroidal circulation impairment correlates with its pathogenesis. We report a rare case with simultaneous onset of AMN and central retinal vein occlusion (CRVO), which is a retinal circulation disorder.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 44-year-old woman complained of central visual loss of the left eye for the previous 2 weeks. The patient's visual acuity was 0.5 in the left eye (OS). Fundoscopic examination revealed a wedge-shaped, dark reddish-brown lesion at the macula, and CRVO-like retinal hemorrhages OS. Fluorescein angiography revealed retinal vasculitis and hypofluorescence corresponding to the macular lesion. The patient's scanning laser ophthalmoscopy infrared imaging result led to a diagnosis of AMN. Two weeks after corticosteroid pulse therapy, her visual acuity improved to 1.2 OS, with improvement of macular findings and Humphrey perimetry. When the dose of oral corticosteroid was decreased, the AMN lesion worsened, with recurrence of retinal hemorrhages. Visual functions improved again after an increased dose of corticosteroid.
  
  
  CONCLUSIONS
  These results suggest that circulatory disorders almost simultaneously occurred in choroidal and retinal vessels, resulting in the onset of both AMN and CRVO.
authors.affiliation: Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Kiriko
authors.initials: K
authors.lastname: Hirooka
authors.forename: Wataru
authors.initials: W
authors.lastname: Saito
authors.forename: Kousuke
authors.initials: K
authors.lastname: Noda
authors.forename: Susumu
authors.initials: S
authors.lastname: Ishida
keywords: choroidal circulation; optical coherence tomography; retinal circulation; systemic corticosteroid therapy