Case Report: Recurrent Acute Macular Neuroretinopathy-Monitoring Recovery with Multimodal Imaging.

SIGNIFICANCE: Acute macular neuroretinopathy (AMN) is a rare, nonprogressive condition affecting the outer retina that can be diagnosed clinically using widely available multimodal imaging techniques. This case report presents an exceedingly rare same-eye recurrence of AMN and describes the characteristic imaging findings of this unique, not fully understood clinical entity. PURPOSE: The following report provides a detailed account of recurrent AMN from 4 hours of symptom onset to 4 months with repeat multimodal imaging captured at different visits. This report also devotes some discussion to the current understanding of its pathophysiology, associations, management, and imaging characteristics. CASE REPORT: A 32-year-old woman with unilateral recurrent AMN was monitored frequently with various multimodal imaging from 4 hours after onset of new scotoma to 4 months. The primary finding in the acute stage was a hyperreflective lesion of the outer nuclear and outer plexiform layers followed by disruption of underlying external limiting membrane, ellipsoid zone, and photoreceptors. This resolved into stable outer nuclear layer thinning and subtle disruption of the deeper layers after 1 week. Fundus photography revealed a red-brown petaloid lesion adjacent to the fovea, and optical coherence tomography angiography revealed subtle decreased perfusion of the choriocapillaris layer throughout follow-up. CONCLUSIONS: Acute macular neuroretinopathy is a rare nonprogressive condition of the outer retina most often affecting otherwise healthy young female individuals and is most associated with recent flu-like illness and oral contraceptives. The underlying mechanism of AMN remains unknown, but modern imaging techniques have elucidated the disease locus to be choroidal and/or deep capillary plexus. It is important for eye care providers to recognize AMN as a clinical entity distinct from other retinal conditions that require different management.

Methodological considerations for detection of terrestrial small-body salamander eDNA and implications for biodiversity conservation.

Environmental DNA (eDNA) can be used as an assessment tool to detect populations of threatened species and provide fine-scale data required to make management decisions. The objectives of this project were to use quantitative PCR (qPCR) to: (i) detect spiked salamander DNA in soil, (ii) quantify eDNA degradation over time, (iii) determine detectability of salamander eDNA in a terrestrial environment using soil, faeces, and skin swabs, (iv) detect salamander eDNA in a mesocosm experiment. Salamander eDNA was positively detected in 100% of skin swabs and 66% of faecal samples and concentrations did not differ between the two sources. However, eDNA was not detected in soil samples collected from directly underneath wild-caught living salamanders. Salamander genomic DNA (gDNA) was detected in all qPCR reactions when spiked into soil at 10.0, 5.0, and 1.0 ng/g soil and spike concentration had a significant effect on detected concentrations. Only 33% of samples showed recoverable eDNA when spiked with 0.25 ng/g soil, which was the low end of eDNA detection. To determine the rate of eDNA degradation, gDNA (1 ng/g soil) was spiked into soil and quantified over seven days. Salamander eDNA concentrations decreased across days, but eDNA was still amplifiable at day 7. Salamander eDNA was detected in two of 182 mesocosm soil samples over 12 weeks (n = 52 control samples; n = 65 presence samples; n = 65 eviction samples). The discrepancy in detection success between experiments indicates the potential challenges for this method to be used as a monitoring technique for small-bodied wild terrestrial salamander populations.