title: Acute macular neuroretinopathy associated with subclinical cytomegalovirus infection.
abstract: OBJECTIVE
  To report a case of bilateral acute macular neuroretinopathy (AMN) occurring in a 32-year-old woman, analyzed using the multimodal imaging technique.
  
  
  METHODS
  A 32-year-old Caucasian woman presented with 20 days history of acute onset of blurred vision in the right eye. The best-corrected visual acuity (BCVA) was 0.8 and 1.0 in the right and left eyes, respectively. She reported a lower urinary tract infection associated with fever, 7 days before the onset of the ocular symptoms. Serological tests demonstrated the presence of IgM specific for cytomegalovirus (CMV), while all the other laboratory tests were negative. SD-OCT exhibited the disruption of the inner segment-outer segment junction, associated with hyper-reflectivity of a thickened outer plexiform layer overlying such area associated with thinning of the outer nuclear layer. The patient was diagnosed with AMN and received a corticosteroid treatment. During all the follow-up, OCT features did not change, although BCVA improved. Four months after the first visit, we found also in the left eye a subfoveal IS/OS disruption but differently from the right eye, in which the abnormalities persisted during all the follow-up visits, in the left one they disappeared only after a month. The IgM specific for the CMV remained positive during the whole follow-up.
  
  
  CONCLUSIONS
  To our knowledge, this is the first patient reported with a diagnosis of AMN associated with persisting presence of IgM specific for CMV.
authors.affiliation: Eye Clinic, Polytechnic University of Marche, Ancona, Italy.|Eye clinic, University Hospital "Ospedali Riuniti", Ancona, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pirani
authors.affiliation: Eye Clinic, Polytechnic University of Marche, Ancona, Italy. edoardo.cavallero1986@gmail.com.|Eye clinic, University Hospital "Ospedali Riuniti", Ancona, Italy. edoardo.cavallero1986@gmail.com.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Cavallero
authors.affiliation: Eye Clinic, Polytechnic University of Marche, Ancona, Italy.|Eye clinic, University Hospital "Ospedali Riuniti", Ancona, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Mariotti
authors.affiliation: Eye Clinic, Polytechnic University of Marche, Ancona, Italy.|Eye clinic, University Hospital "Ospedali Riuniti", Ancona, Italy.
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Neri
authors.affiliation: Eye Clinic, Polytechnic University of Marche, Ancona, Italy.|Eye clinic, University Hospital "Ospedali Riuniti", Ancona, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Nicolai
authors.affiliation: Eye Clinic, Polytechnic University of Marche, Ancona, Italy.|Eye clinic, University Hospital "Ospedali Riuniti", Ancona, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cesari
authors.affiliation: Eye Clinic, Polytechnic University of Marche, Ancona, Italy.|Eye clinic, University Hospital "Ospedali Riuniti", Ancona, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Carrozzi
authors.affiliation: Eye Clinic, Polytechnic University of Marche, Ancona, Italy.|Eye clinic, University Hospital "Ospedali Riuniti", Ancona, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Giovannini
mesh_terms: D000208:Acute Disease; D000328:Adult; D000914:Antibodies, Viral / Q000276:immunology*; D003587:Cytomegalovirus / Q000276:immunology*; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis* / Q000821:virology; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000821:virology; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D000914:Antibodies, Viral
keywords: Acute macular neuroretinopathy; Cytomegalovirus; Optical coherence tomography; Photoreceptor inner segment/outer segment junction