Optical coherence tomography angiography and multifocal electroretinogram findings in paracentral acute middle maculopathy

Abstract

Paracentral acute middle maculopathy (PAMM) is an optical coherence tomography (OCT) finding seen in patients with retinal capillary ischemia. In this case report, we present a case of PAMM after a transient central retinal artery occlusion and the multifocal electroretinogram (mfERG) and other multimodal imaging findings. Clinical examination, OCT angiography, OCT en face , fluorescein angiography, and visual fields were performed at the baseline and follow-up examinations. As a result, we identified in this PAMM case evidence of hypoperfusion in both the choriocapillaris as well as the deep capillary plexus. To the best of our knowledge, the involvement of choriocapillaris has not been reported previously in the literature. Moreover, we concluded that mfERG constitutes a useful investigation in PAMM and this is the first mfERG findings to be presented for a PAMM case specifically.

Case Series: Paracentral Acute Middle Maculopathy as a Sign of Severe Systemic Vasculopathy

“…6 In addition, some evidence revealed that the choriocapillaris may also be hypoperfused along with the deep capillary plexus in PAMM lesions. 7 Retinal changes 2.5-5 years after acute PAMM lesions include excavation of the inner retinal surface, inner nuclear layer thinning, and presence of abnormal vasculature in the deep capillary plexus. 8 The etiology of PAMM has not been clearly elucidated as causative factors range from the use of vasoconstrictors, such as caffeine, amphetamines, epinephrine, and oral contraceptives, to microvascular diseases, including hypertension, diabetes, and sickle cell disease.…”