Acute macular neuroretinopathy.

A 24-year-old white woman convalescing from a viral upper respiratory infection suddenly developed three positive scotomas around the fixation point in her left eye. The fundus had three corresponding lesions that appeared to be characteristic of acute macular neuroretinopathy. Situated in the fovea, subtle, reddish-brown, wedge- or tear-shaped lesions were best seen with the direct ophthalmoscope using red-free light. Visual acuity was 6/6 (20/20), and peripheral fields were normal. The patient's reproduction of the scotomas on an Amsler grid sheet mirrored the observed ophthalmoscopic findings. Fluorescein angiograms were normal. She had been taking oral contraceptives for many years. Although viral illness and oral contraceptives have been associated with acute macular neuroretinopathy, no etiology was proven, and no treatment is known. The patient remains symptomatic after a six-month follow-up.