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Case Report
Acute macular neuroretinopathy in a second-trimester pregnant patient: A case report and literature review
1 MBChB, Assistant Registrar, General Surgery, Mubarak AlKabeer Hospital, Ministry of Health, Kuwait City, Kuwait
2 MD, Assistant Registrar, General Surgery, AlFarwaniyah Hospital, Ministry of Health, Kuwait City, Kuwait
3 MD, Postgraduate Year 5, Kuwaiti Board of Ophthalmology, Ministry of Health, Kuwait City, Kuwait
4 Senior Registrar of Ophthalmology, Kuwaiti Board of Ophthalmology Ministry of Health, Kuwait City, Kuwait
5 FRCSC, Consultant of Ophthalmology, AlBahar Hospital, Ministry of Health, Kuwait City, Kuwait
Address correspondence to:
Noor AlAli
MBChB, Assistant Registrar, General Surgery, Mubarak AlKabeer Hospital, Ministry of Health, Kuwait City,
Kuwait
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Article ID: 100059Z17NA2026
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How to cite this article
AlAli N, AlBaloul D, Shamsah A, AlKandari A, AlAli A. Acute macular neuroretinopathy in a second-trimester pregnant patient: A case report and literature review. J Case Rep Images Opthalmol 2026;9(2):28–34.ABSTRACT
This case report presents a rare occurrence of acute macular neuroretinopathy in a 24-year-old healthy woman, who is a primigravida in her second trimester. She presented with a sudden onset of paracentral vision loss in the oculus sinister. A fundus examination showed a parafoveal wedge-shaped brown-red lesion in the macula. An optical coherence tomography scan showed abnormal hyperreflectivity in both the outer plexiform and outer nuclear layers with ellipsoid zone disruption. Conservative management was recommended, and the patient was followed up one month later with an improvement in her paracentral vision loss but with new onset metamorphopsia. Repeat optical coherence tomography showed complete resolution of the hyperreflectivity in the outer retina layers with persistent disruption of the ellipsoid zone in the subfoveal area in the oculus sinister. In this case report, we present acute macular neuroretinopathy in an antepartum patient, accompanied by a literature review, highlighting pregnancy and its hypercoagulable state as a potential contributor to this condition.
Keywords: Acute macular neuroretinopathy, Ellipsoid zone, Metamorphopsia, Optical coherence tomography, Outer nuclear layer, Outer plexiform later, Paracentral vision loss
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Acknowledgments
AI was used to assist with language editing and to improve the clarity and organization of the manuscript text, as well as to assist with the organization of some references. The AI tool used was ChatGPT (GPT-5.5), developed by OpenAI.
Author ContributionsNoor AlAli - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Daniah AlBaloul - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ali Shamsah - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Aseel AlKandari - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alaa AlAli - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Noor AlAli et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
