Acute Macular Neuroretinopathy

This 42 year old female presented with complaints of decrease vision in the left eye with a grayish spot in line of vision for 5 days. Her vision was 20/25 uncorrected. The patient had normal pupils and confrontation fields were full to finger count. The slit lamp was normal. The fundus exam showed a normal right eye and a slight graying patch nasal to the fovea in the left eye. The above images show the grayish patch (see top images yellow arrows). The OCT (left image- yellow arrow) shows the same area. The patient was diagnosed with acute macular neuroretinopathy, which is a rare condition of unknown causes. In her case she was on pain medication due to back pain which may be the cause of this diagnosis. She was asked to discontinue all the pain medications and return in 6 weeks. At the 6 week visit, the gray was resolved, but could come back in the future