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Case Reports
. 2021 Dec 28;51(6):403-406.
doi: 10.4274/tjo.galenos.2021.50207.

Bilateral Sequential Paracentral Acute Middle Maculopathy

İlkay Kılıç Müftüoğlu  1 , Ecem Önder Tokuç  2 , V Levent Karabaş  3
Affiliations
Case Reports

Bilateral Sequential Paracentral Acute Middle Maculopathy

İlkay Kılıç Müftüoğlu et al. Turk J Ophthalmol. .

Abstract

We aim to present a case with bilateral sequential paracentral acute middle maculopathy (PAMM). A 57-year-old man presented with paracentral scotoma in the left eye. The patient's multimodal imaging findings were consistent with PAMM in the left eye. Extensive systemic work-up revealed hypertension and a history of cerebrovascular event. One year after initial presentation, the patient had a subsequent decrease in visual acuity in the right eye and developed optical coherence tomography findings consistent with PAMM, whereas the left eye showed resolved PAMM findings. Although rare, PAMM can occur bilaterally. Clinicians should monitor unilateral PAMM patients with systemic vasculopathy for involvement in the fellow eye.

Keywords: PAMM; cerebrovascular event; hypertension; paracentral acute middle maculopathy.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Fundus fluorescein angiography shows complete perfusion of the retinal vessels without abnormal leakage in both eyes at initial visit (A, B). Spectral domain optical coherence tomography (SD-OCT) scans of the left eye demonstrate a hyperreflective parafoveal band at the level of the inner nuclear and inner plexiform layers (C). The right eye of the patient shows no abnormality on SD-OCT (D)
Figure 2
Figure 2
Fundus fluorescein angiography shows complete perfusion of the retinal vessels in both eyes (A, B). Spectral domain optical coherence tomography (SD-OCT) scan of the left eye shows inner nuclear layer thinning associated with outer plexiform layer elevation consistent with resolved paracentral acute middle maculopathy (PAMM) (C). SD-OCT scan of the right eye reveals a hyperreflective parafoveal band at the level of the inner nuclear and inner plexiform layers corresponding to acute PAMM (D). OCT angiography shows normal perfusion of the deep and superficial capillary plexuses in the left eye (E, G) and decreased perfusion of the deep capillary plexus but normal perfusion of the superficial capillary plexus in the right eye (F, H)
Figure 3
Figure 3
Retinal sensitivity maps containing interpolated retinal sensitivity measures. Microperimetry images show decreased retinal sensitivity in red (A, B)
See this image and copyright information in PMC

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