Paracentral Acute Middle Maculopathy Associated With Idiopathic Intracranial Hypertension

Denny, Matthew R; Kalevar, Ananda; Chen, Judy J; Johnson, Robert N.

doi:10.1097/icb.0000000000000846

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…In PAMM pathogenesis, several associations have been proposed with ocular disorders, especially occlusions of the retinal vein or artery [39, 40], hypertensive and diabetic retinopathies [41], congenital glaucoma [42], ocular surgery [43, 44], and local retrobulbar anesthesia [45]. The most common systemic diseases associated with PAMM are intracranial hypertension [46], meningitis [47], vascular surgery [48], pregnancy [49], and specific drugs assumption [50, 51]. As observed in AMN, in some patients, PAMM was linked to a recent viral flu-like disease [52].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Diagnostic Findings of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy in the COVID-19 Era

Premi,

Acampora,

Salmi

et al. 2023

Ophthalmologica

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Introduction: Growing evidence suggest an association between the infection from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and eye disorders. The aim of this review is to analyze the clinical presentation and diagnostic features of acute macular neuroretinopathy (AMN) and paracentral acute middle maculopathy (PAMM) associated with COVID-19 infection. The features are then compared with previous reports regarding these retinal disorders, to recognize possible specific characteristics and to assess the role of multimodal ophthalmic imaging. Methods: A literature search was performed by consulting PubMed, Scopus and Embase. The following terms were searched: “(COVID-19 OR SARS-CoV-2 OR coronavirus) AND ((acute macular neuroretinopathy) OR (paracentral acute middle maculopathy))”. Inclusion criteria were as follow: 1) publication date from January 31st, 2020 to January 31st, 2022; 2) English language; 3) original research or case report; 4) free full-text availability. Results: Optical coherence tomography (OCT) findings in AMN patients were hyper-reflectivity (HR) of the outer plexiform layer (OPL), of the outer nuclear layer (ONL), and ellipsoid or interdigitate zones (EZ and IZ, respectively) disruption. In most cases, the presence of HR and EZ/IZ abnormalities resulted combined. When performed, OCT angiography (OCTA) identified attenuation of signal of the deep capillary plexus (DCP). The most common OCT finding in PAMM was an alteration of the inner nuclear layer (INL), associated with other areas of HR, while no signs of EZ/IZ disruption were detected. When performed, OCT-A showed the attenuation of signal of both the DCP, and the superficial capillary plexus (SCP) Discussione/Conclusion: In this review we reported a case series of AMN and PAMM in patients with a previous or concomitant infection from SARS-CoV-2. The microvascular changes in these cases are highlighted by the OCTA scans. Even if we are far from the determination of a direct link between COVID-19 and these retinal disorders, we could hypothesize that the vascular alterations associated with Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) infection could be a possible risk factor for both AMN and PAMM.

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Section: Discussionmentioning

confidence: 99%

Clinical and Diagnostic Findings of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy in the COVID-19 Era

Premi,

Acampora,

Salmi

et al. 2023

Ophthalmologica

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“…Recientemente se ha reportado su asociación con hipertensión endocraneana (Denny et al, 2019) y síndrome antifosfolípidos (Trese et al, 2017). Por otro lado, la PAMM puede ser una condición idiopática y estar presente en pacientes sin comorbilidades (Chen & Hu, 2017).…”

Section: Discussionunclassified

Maculopatía media paracentral aguda: a propósito de un caso y revisión de la literatura.

Sanhueza

Salazar

Contreras

2020

ARS med

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Introducción: la maculopatía media paracentral aguda (PAMM) es una entidad descrita en la tomografía de coherencia óptica de dominio espectral (SD-OCT). Se caracteriza por la presencia de una banda hiperrefringente de localización parafoveal en las capas medias retinales y se manifiesta por la aparición de escotomas paracentrales. En este artículo se presenta un caso clínico con el diagnóstico de PAMM y una breve revisión de la literatura. Métodos: se solicitó consentimiento informado escrito del paciente bajo la aprobación del comité ético-científico de la Facultad de Medicina de la Pontificia Universidad Católica de Chile. La revisión de la literatura se realizó mediante una estrategia de búsqueda que incluyó los términos explicitados en las palabras clave. Resultados: el paciente consulta por un escotoma paracentral superior en el ojo derecho (OD). En la autofluorescencia se observó una lesión hipoautofluorescente parafoveal inferior del OD. La angiografía retinal mostró tenue filtración en la misma zona, sin signos de oclusión arterial. En la SD-OCT del OD, se observó una lesión hiperrefringente parafoveal inferior en las capas medias retinales. El estudio sistémico descartó causas infeccioso-inflamatorias y vasculares. A partir de lo anterior, se realizó el diagnóstico de PAMM. Conclusiones: la presentación clínica y los resultados obtenidos fueron concordantes con lo reportado en la literatura respecto a la PAMM. Actualmente el manejo se basa en buscar y controlar condiciones relacionadas, puesto que no se ha descrito tratamiento específico. En este caso, se descartaron causas secundarias y se decidió la observación clínica.

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“…Most patients with these retinal ischemia signs have retinal vascular disease or systemic vasculopathic risk factors. Recently, there have been a few case reports describing PAMM in eyes with optic nerve disorders including meningitis-associated optic neuritis (4) and idiopathic intracranial hypertension–associated optic disc edema (5). Inflammatory occlusion in the former (4) and perfusion occlusion from compression in the later case (5) were the suggested underlying pathophysiology that predisposed to microvascular retinal ischemia.…”

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confidence: 99%

Paracentral Acute Middle Maculopathy Mimicking Retrobulbar Optic Neuropathy

Scott

Bhat²,

Bindiganavile³

et al. 2020

Journal of Neuro-Ophthalmology

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A 70-year-old woman presented with acute awareness of decreased color vision in her right eye. Fundus examination and a flash electroretinography (ERG) were both normal. A multifocal ERG (mfERG) however revealed foveal depression, and thinning of inner nuclear layer was noted on macular optical coherence tomography (OCT), and a diagnosis of resolved paracentral acute middle maculopathy was made. Clinicians should be aware of the complementary role of OCT and mfERG in unexplained acute central visual loss to distinguish retinal from neuroophthalmic etiologies. Structural ocular imaging with OCT shows features of inner, middle, and outer retinal localizations to the visual loss.

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Paracentral Acute Middle Maculopathy Associated With Idiopathic Intracranial Hypertension

Cited by 10 publications

References 11 publications

Clinical and Diagnostic Findings of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy in the COVID-19 Era

Clinical and Diagnostic Findings of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy in the COVID-19 Era

Maculopatía media paracentral aguda: a propósito de un caso y revisión de la literatura.

Paracentral Acute Middle Maculopathy Mimicking Retrobulbar Optic Neuropathy

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