Medical hypothesis discovery and innovation in ophthalmology

Abstract

Background: Acute macular neuroretinopathy (AMN) is a rare but increasingly reported retinal disorder that predominantly affects young women and is characterized by acute-onset paracentral scotomas and distinctive parafoveal macular lesions. Following its first report in 1975 as an inner retinal disease, a considerable body of work has been produced, expanding on its clinical presentation and systemic associations. Aim of this review is to synthesize the current understanding of AMN, including existing controversies on nomenclature.
Methods: A literature search was conducted in PubMed/MEDLINE for English-language articles published up to 31 July 2025. Search terms included “acute macular neuroretinopathy” and “acute macular outer retinopathy”. Additional relevant sources were identified through manual screening of reference lists and targeted updating of the literature through 28 August 2025. Relevant articles were selected for inclusion in this narrative review based on the authors’ judgment of relevance to the review aims.
Results: Multiple cases of AMN in association with a variety of ocular and systemic conditions have been reported. Reported associations include viral illnesses such as influenza, Dengue fever, oral contraceptive use, vasoconstrictive agents, non-ocular trauma, and vaccination. An increased incidence of AMN was reported at a single center during the coronavirus (COVID-19) pandemic. Advances in multimodal retinal imaging, particularly optical coherence tomography (OCT) and OCT angiography, have led to a more precise localization and insight into the pathogenesis of the disease in the outer retinal layers. These findings have prompted some authors to suggest renaming the condition acute macular outer retinopathy (AMOR) to better reflect the anatomical involvement.
Conclusions: AMN appears to primarily affect the outer retinal layers, with current evidence suggesting a role for underlying vascular impairment in its pathogenesis. Although “AMOR” may offer a more anatomically precise description, AMN remains widely used in the academic literature and continues to be both appropriate and accepted. Further research is needed to elucidate the underlying pathophysiology, precisely localize the site of vascular impairment, and explore potential therapeutic strategies. In this context, consistent terminology is essential, and the continued use of the acronym “AMN” is supported by both clinical and historical considerations.