Detection of paracentral acute middle maculopathy (PAMM) can prevent blindness and death

Abstract

Depth resolved imaging tools such as optical coherence tomography (OCT) are at the forefront of a new era of retinal diagnostics. These advancements have remarkably broadened our understanding of macular ischemia and the structure of the retinal capillary plexus (RCP). Because of the predominant vertical organization of the RCP, the middle retinal layer is at greater risk of ischemia and infarction. Paracentral acute middle maculopathy (PAMM) is a manifestation of this risk and is the result of infarction of the inner nuclear layer (INL), detectable on OCT as a hyperreflective band within the INL. On OCT angiography (OCTA), PAMM is the result of hypoperfusion of the deep retinal vascular complex i.e the intermediate retinal capillary plexus and the deep retinal capillary plexus.