Paracentral Acute Middle Maculopathy Associated With Bilateral Optic Disk Swelling and Meningitis

Zhao, Zhenyang; Faith, Parker; Pakzad-Vaezi, Kaivon; Chu, Zhongdi; Wang, Ke; Mudumbai, Raghu C.; Rezaei, Kasra A.

doi:10.1097/icb.0000000000000671

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…However, while OCTA showed there were no abnormalities in the SPC in both of our cases, our results did show there was decreased flow in conjunction with dilation of the capillaries around the lesion in DCP even at 2.5 and 5 years after the onset (Figure 2). Previous studies using OCTA to examine PAMM have reported finding retinal vascular changes in the DCP, which include flow abnormalities and dilation of the capillaries during the acute phase of PAMM 3,4,7,8. Follow-up OCTA images have shown that these vascular changes remain for about 1 month 4,8.…”

Section: Discussionmentioning

confidence: 96%

“…Previous studies using OCTA to examine PAMM have reported finding retinal vascular changes in the DCP, which include flow abnormalities and dilation of the capillaries during the acute phase of PAMM 3,4,7,8. Follow-up OCTA images have shown that these vascular changes remain for about 1 month 4,8. Although mild phenotypes of PAMM exhibit complete recovery of the retinal vasculature in only a few months, 7 our data demonstrated that the abnormalities of the retinal vasculature and structure were present for years.…”

Section: Discussionmentioning

confidence: 99%

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<p>Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy</p>

Nakamura¹,

Katagiri²,

Hayashi³

et al. 2019

IMCRJ

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Objective: To describe longitudinal retinal changes in two cases of isolated paracentral acute middle maculopathy (PAMM). Case series: We reported two cases (64 and 67-year-old men) with isolated PAMM, who were followed-up for over 5 and 2.5 years, respectively. Both cases exhibited similar clinical natural histories. The first examinations took place several days after onset, with funduscopy showing that both cases exhibited paracentral scotoma with good visual acuity and small gray lesions, while optical coherence tomography (OCT) showed the presence of a hyperreflective band that ranged from the inner plexiform layer to the outer plexiform layer (OPL). The lesions became unremarkable within 1 month. The hyperreflective band also became unremarkable and was limited to the inner nuclear layer (INL) within 1 month, with the band disappearing within several months. Subsequently, OCT showed there was a thin and irregular INL and OPL, an excavated change of the inner retinal surface, along with outer nuclear layer (ONL) thickening. After several years, OCT angiography demonstrated normal flow of macular capillaries in the superficial capillary plexus, and decreased flow in the lesion with dilation of the capillaries around the area in the deep capillary plexus (DCP). Focal serous retinal detachment (SRD) occurred in one case after 4–5 years. Conclusion: Our findings indicated that long-term retinal changes in PAMM resulted in excavation of the inner retinal surface, INL thinning, ONL thickening and abnormal vasculature, especially in the DCP. Focal SRD may be a rare complication that can present at 4 years after onset.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

<p>Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy</p>

Nakamura¹,

Katagiri²,

Hayashi³

et al. 2019

IMCRJ

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“…2 We contrast this with a case of PAMM associated with optic neuritis, in which the proposed mechanism was an inflammatory occlusion of retinal capillaries. 10…”

Section: Discussionmentioning

confidence: 99%

“…2 We contrast this with a case of PAMM associated with optic neuritis, in which the proposed mechanism was an inflammatory occlusion of retinal capillaries. 10 As more cases of PAMM are identified, and further characterized with improved and novel imaging modalities, we expect to learn of many more associated conditions. To the best of our knowledge, this is the first report of a PAMM lesion associated with IIH.…”

Section: Discussionmentioning

confidence: 99%

Paracentral Acute Middle Maculopathy Associated With Idiopathic Intracranial Hypertension

Denny

Kalevar

Chen

et al. 2021

RETINAL Cases &Amp; Brief Reports

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Purpose: Paracentral acute middle maculopathy (PAMM) is a recently identified clinical entity with numerous retinal vascular and systemic associations. To our knowledge, this is the first reported case of PAMM associated with idiopathic intracranial hypertension.Methods: A case is presented with multimodal imaging.Results: A patient with idiopathic intracranial hypertension is found to have the characteristic clinical, spectral domain optical coherence tomography, and OCT angiography findings associated with PAMM.Conclusion: Paracentral acute middle maculopathy is believed to arise from a microvascular insult to the retinal deep capillary plexus. We add a previously undescribed association with idiopathic intracranial hypertension to the list of etiologies that can cause PAMM.

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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 Bilateral Optic Disk Swelling and Meningitis

Cited by 11 publications

References 10 publications

<p>Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy</p>

<p>Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy</p>

Paracentral Acute Middle Maculopathy Associated With Idiopathic Intracranial Hypertension

Paracentral Acute Middle Maculopathy Mimicking Retrobulbar Optic Neuropathy

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