Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 1;42(3):476-484.
doi: 10.1097/IAE.0000000000003339.

PARACENTRAL ACUTE MIDDLE MACULOPATHY IN GIANT CELL ARTERITIS

Kevin Mairot  1 , Thomas Sené  1 , Augustin Lecler  1 , Manon Philibert  1 , Gaëlle Clavel  1 , Anaelle Hemmendinger  2 , Danièle Denis  2 , Catherine Vignal-Clermont  1 , Martine Mauget-Faÿsse  1 , Rabih Hage  1
Affiliations

PARACENTRAL ACUTE MIDDLE MACULOPATHY IN GIANT CELL ARTERITIS

Kevin Mairot et al. Retina. .

Abstract

Purpose: To report the occurrence of paracentral acute middle maculopathy (PAMM) in giant cell arteritis (GCA), describe its features and outcomes, and identify risk factors associated with PAMM in patients with GCA.

Methods: Review of medical records of patients with GCA who were examined in the Rothschild Foundation Hospital. Patients were divided into three groups: GCA with PAMM (Group 1), GCA with ophthalmic involvement but without PAMM (Group 2), and GCA without ophthalmic involvement (Group 3). We analyzed the data for age, sex, medical history, laboratory testing, visual acuity, and posterior segment vascular involvement.

Results: Among the 96 patients who met the inclusion criteria, 52 had ophthalmic involvement, and 16 patients were included in Group 1 (GCA with PAMM). In this subgroup, the mean age was 81.6 years and was found to be older than other groups. The visual prognosis was similar between Groups 1 and 2. Of the 20 eyes with PAMM, 35% were also associated with homolateral anterior ischemic optic neuropathy. No statistical difference was found in initial symptoms, signs, and laboratory testing.

Conclusion: Paracentral acute middle maculopathy is frequently observed lesions in ocular GCA. Patients can present with isolated findings of PAMM as the only indication of GCA. Optical coherence tomography of the macula should be routinely performed in patients with suspected GCA, specifically if they complain of visual changes, to look for signs of ischemia in the middle layers of the retina. Isolated PAMM should raise suspicion for GCA in patients at risk.

PubMed Disclaimer

References

    1. Sarraf D, Rahimy E, Fawzi AA, et al. Paracentral acute middle maculopathy: a new variant of acute macular neuroretinopathy associated with retinal capillary ischemia. JAMA Ophthalmol 2013;131:1275–1287.
    1. Nemiroff J, Kuehlewein L, Rahimy E, et al. Assessing deep retinal capillary ischemia in paracentral acute middle maculopathy by optical coherence tomography angiography. Am J Ophthalmol 2016;162:121–132.e1.
    1. Chen X, Rahimy E, Sergott RC, et al. Spectrum of retinal vascular diseases associated with paracentral acute middle maculopathy. Am J Ophthalmol 2015;160:26–34.e1.
    1. Moura-Coelho N, Gaspar T, Ferreira JT, et al. Paracentral acute middle maculopathy-review of the literature. Graefes Arch Clin Exp Ophthalmol 2020;258:2583–2596.
    1. Yu S, Pang CE, Gong Y, et al. The spectrum of superficial and deep capillary ischemia in retinal artery occlusion. Am J Ophthalmol 2015;159:53–63.e1-2.