Paracentral Acute Middle Maculopathy and the Ischemic Cascade: Toward Interventional Management

En face optical coherence tomography for diagnosis of unexplained snowflake scotoma

“…the patchy pattern of middle retinal thinning that persisted 6 months after the acute PAMM lesions had faded. As illustrated by Zhao et al, 5 the striking configuration of acute perivenular PAMM perfectly matches our patient's description of her highly specific, complex snowflake scotoma, which had faded along the acute lesions. For patients with old PAMM lesions, use of en face OCT when the fundus examination and even standard spectral-domain OCT appear grossly normal can quickly confirm the diagnosis, saving the patient from unnecessary testing (including magnetic resonance imaging in this case) and prompting appropriate referral for stroke work-up.…”

A Case of Paracentral Acute Middle Maculopathy (PAMM) Associated with Cilioretinal Artery Occlusion. The Contribution of OCT-A to the Understanding of PAMMʼs Pathophysiology

“…Another element to support the ischemic cause of PAMM is the fact that unlike other published cases 3 , 4 , in our case, PAMM was adjacent to the zone of ischemia, as shown by SD-OCT and OCT-A scans. The vascular density decrease of DCP correlates well with the hyperreflective band in the INL that corresponds to PAMM.…”

A review of the management of central retinal artery occlusion

“…[ 14 ] Paracentral acute middle maculopathy, which represents ischemic injury of the middle retina or inner retinal layers as a result of hypoperfusion of the retinal capillary plexus, has also been reported in partial CRAO [ Figure 8 ]. [ 15 ]…”