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Case Reports
. 2022 Sep 1;16(5):558-560.
doi: 10.1097/ICB.0000000000001054. Epub 2020 Sep 18.

PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH BRANCH RETINAL ARTERY OCCLUSION DUE TO POLYCYTHEMIA IN A PATIENT WITH TETRALOGY OF FALLOT

Nurullah Koçak  1 , Bilgehan Erduran, Mustafa Subaşı, Volkan Yeter
Affiliations
Case Reports

PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH BRANCH RETINAL ARTERY OCCLUSION DUE TO POLYCYTHEMIA IN A PATIENT WITH TETRALOGY OF FALLOT

Nurullah Koçak et al. Retin Cases Brief Rep. .

Abstract

Purpose: To describe the occurrence of paracentral acute middle maculopathy (PAMM) associated with branch retinal artery occlusion secondary to polycythemia in a patient with tetralogy of Fallot.

Methods: Case report.

Results: A 30-year-old man presented with acute vision loss and superior visual deficit in his left eye for two days. His medical record had a tetralogy of Fallot. Complete blood count showed an erythrocyte count of 9.88 million/µL (4.4-5.6), hemoglobin of 17.7 g/dL (13.5-16.9), and hematocrit of 65.4% (40-49). The best-corrected visual acuity was 20/25 in the left eye, and a diagnosis of left inferotemporal branch retinal artery occlusion was made. Spectral-domain optical coherence tomography revealed a characteristic hyperreflective band-like lesion on the inner nuclear layer consistent with PAMM.

Conlusion: Polycythemia may be a trigger for branch retinal artery occlusion-associated PAMM. We suggest a new precursor cause of PAMM that is previously undescribed.

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Conflict of interest statement

None of the authors has any financial/conflicting interests to disclose.

Figures

Fig. 1.
Fig. 1.
A. Multicolor fundus photograph of the left eye showing a deep retinal whitening area around the inferotemporal arcade. B. Optical coherence tomography (a horizontal slab on the fovea) of the left eye showing a hyperreflective band on the level of the INL consistent with PAMM. C. Spectral-domain OCT through the central area of the infarct displays ischemia and hyperreflectivity of both the middle and inner retinal layers.
Fig. 2.
Fig. 2.
Fundus fluorescein angiography exhibits delayed filling in retinal vascular bed in both eyes (frame shown at 38 seconds).
See this image and copyright information in PMC

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