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This abstract is assigned to session BOG-SBO: Medisch netvlies/ Rétine médicale

Title	Acute macular neuroretinopathy after caesarian section
Abstract Nr.	244

Purpose	To report a case of acute macular neuroretinopathy (AMN) probably related to hypotension during Caesarian section.
Methods	A 30-year old woman was examined after she was referred with bilateral U-shaped paracentral scotomata following a Caesarian section (C-section) under epidural anaesthesia without epinephrine. The patient was followed up during a period of two years and underwent a full clinical work-up as well as extensive additional testing including fundoscopy, fluorescein angiography (FA), visual fields (VF), optical coherence tomography (OCT), pattern electroretinography (pERG) and pattern visual evoked potentials (pVEP).
Results	The patient was known to suffer from arterial hypotension. During the C-section the patient very briefly lost consciousness. At presentation BCVA was 12/10. VF analysis revealed bilateral parafoveal U-formed scotomata. Initial fundoscopy and FA showed petaloid macular lesions with a darker aspect. Later on both alterations of the retinal pigment epithelium and fine white deposits were seen in the macular area. The N95 of the pERG was mildly subnormal, while on full-field flash ERG only a slightly reduced photopic response was noted. The pVEP responses had small amplitudes and normal latencies. On OCT a band of higher reflectivity overlying the RPE/CC complex was detectable in the (para-) foveal area, as well as outer retinal thinning in the superior macula, congruous with the scotomata. During follow-up, the scotomata gradually diminished in density, albeit that they never cleared up completely.
Conclusion	AMN can develop during a C-section under epidural anaesthesia without epinephrine.

Author 1

Last name	CORVER
Initials	HD
Department	UGent
City	Gent

Author 2

Last name	GOETHALS
Initials	T
Department	Maria's Voorzienigheid Hospital
City	Kortrijk

Author 3

Last name	DE LAEY
Initials	JJ
Department	UGent
City	Gent

Author 4

Last name	LEROY
Initials	BP
Department	UGent
City	Gent