Paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusion
A 79-year-old man presented with unilateral unexplained sudden onset visual loss in the setting of central retinal vein occlusion (CRVO). Non ischemic CRVO in the right eye (RE) was confirmed on fluorescein angiography. Spectral domain optical coherence tomography (SD-OCT) showed absence of macular...
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Wolters Kluwer Medknow Publications
2019-04-01
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Series: | Saudi Journal of Ophthalmology |
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doaj-17da13860c4f444eb7b0c9e23c1a0eae2021-04-02T20:12:38ZengWolters Kluwer Medknow PublicationsSaudi Journal of Ophthalmology1319-45342019-04-01332168171Paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusionGiuseppe Casalino0Michele Coppola1Oliva Earley2Fabio Contieri3Francesco Bandello4Usha Chakravarthy5Ophthalmology Macular Service, Belfast Health and Social Care Trust and Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK; Department of Ophthalmology, Scientific Institute San Raffaele, Vita-Salute University, Milan, Italy; Ophthalmology Unit, Ospedale di Desio, ASST Monza, Italy; Corresponding author at: Department of Ophthalmology, Scientific Institute San Raffaele, Vita-Salute University, Milan, Italy.Ophthalmology Unit, Ospedale di Desio, ASST Monza, ItalyOphthalmology Macular Service, Belfast Health and Social Care Trust and Centre for Experimental Medicine, Queen's University Belfast, Belfast, UKDepartment of Ophthalmology, Hospital Universitario Reina Sofia Cordoba, Andalucía, SpainDepartment of Ophthalmology, Scientific Institute San Raffaele, Vita-Salute University, Milan, ItalyOphthalmology Macular Service, Belfast Health and Social Care Trust and Centre for Experimental Medicine, Queen's University Belfast, Belfast, UKA 79-year-old man presented with unilateral unexplained sudden onset visual loss in the setting of central retinal vein occlusion (CRVO). Non ischemic CRVO in the right eye (RE) was confirmed on fluorescein angiography. Spectral domain optical coherence tomography (SD-OCT) showed absence of macular edema and hyperreflective band-like lesions in the middle retinal layers of the RE suggesting a diagnosis of paracentral acute middle maculopathy (PAMM). Patient was observed and after 3 months, best-corrected visual acuity in the RE spontaneously improved from 38 to 56 ETDRS letters. SD-OCT scans showed thinning of the inner nuclear layer of the RE. OCT angiography in the RE revealed a mild attenuation of the vascular flow signal in the superficial capillary plexus and patchy areas of vascular flow void in the deep capillary plexus, as compared to the fellow eye.The present case outlines the importance of recognising PAMM as a cause of unexplained visual loss. In the setting of a CRVO with sudden vision loss and absence of macular edema, clinicians should pay attention to any hyperreflectivity and/or to thinning of the middle retinal layers on SD-OCT. Keywords: Paracentral acute middle maculopathy, Central retinal vein occlusion, spectral domain optical coherence tomography, Deep capillary ischemia, Optical coherence tomography angiographyhttp://www.sciencedirect.com/science/article/pii/S1319453418302789 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Giuseppe Casalino Michele Coppola Oliva Earley Fabio Contieri Francesco Bandello Usha Chakravarthy |
spellingShingle |
Giuseppe Casalino Michele Coppola Oliva Earley Fabio Contieri Francesco Bandello Usha Chakravarthy Paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusion Saudi Journal of Ophthalmology |
author_facet |
Giuseppe Casalino Michele Coppola Oliva Earley Fabio Contieri Francesco Bandello Usha Chakravarthy |
author_sort |
Giuseppe Casalino |
title |
Paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusion |
title_short |
Paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusion |
title_full |
Paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusion |
title_fullStr |
Paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusion |
title_full_unstemmed |
Paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusion |
title_sort |
paracentral acute middle maculopathy as a cause of unexplained visual loss in central retinal vein occlusion |
publisher |
Wolters Kluwer Medknow Publications |
series |
Saudi Journal of Ophthalmology |
issn |
1319-4534 |
publishDate |
2019-04-01 |
description |
A 79-year-old man presented with unilateral unexplained sudden onset visual loss in the setting of central retinal vein occlusion (CRVO). Non ischemic CRVO in the right eye (RE) was confirmed on fluorescein angiography. Spectral domain optical coherence tomography (SD-OCT) showed absence of macular edema and hyperreflective band-like lesions in the middle retinal layers of the RE suggesting a diagnosis of paracentral acute middle maculopathy (PAMM). Patient was observed and after 3 months, best-corrected visual acuity in the RE spontaneously improved from 38 to 56 ETDRS letters. SD-OCT scans showed thinning of the inner nuclear layer of the RE. OCT angiography in the RE revealed a mild attenuation of the vascular flow signal in the superficial capillary plexus and patchy areas of vascular flow void in the deep capillary plexus, as compared to the fellow eye.The present case outlines the importance of recognising PAMM as a cause of unexplained visual loss. In the setting of a CRVO with sudden vision loss and absence of macular edema, clinicians should pay attention to any hyperreflectivity and/or to thinning of the middle retinal layers on SD-OCT. Keywords: Paracentral acute middle maculopathy, Central retinal vein occlusion, spectral domain optical coherence tomography, Deep capillary ischemia, Optical coherence tomography angiography |
url |
http://www.sciencedirect.com/science/article/pii/S1319453418302789 |
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