June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Spectrum of Retinal Vascular Diseases Associated with Paracentral Middle Maculopathy
Author Affiliations & Notes
  • Xuejing Chen
    Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA
  • Ehsan Rahimy
    Wills Eye Hospital, Philadelphia, PA
  • Netan Choudhry
    Herzig Eye Institute, Toronto, ON, Canada
  • Amani A Fawzi
    Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Evanston, IL
  • Allen C Ho
    Wills Eye Hospital, Philadelphia, PA
  • Jean-Pierre Hubschman
    Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA
  • Marion Ronit Munk
    Ophthalmology, Northwestern University Feinberg School of Medicine, Evanston, IL
  • Robert Sergott
    Wills Eye Hospital, Philadelphia, PA
  • Eduardo Cunha Souza
    Department of Ophthalmology, Universidade Federal of Sao Paulo, Sao Paulo, Brazil
  • David Sarraf
    Great Los Angeles Veterans Affairs Healthcare Center, Los Angeles, CA
    Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA
  • Footnotes
    Commercial Relationships Xuejing Chen, None; Ehsan Rahimy, None; Netan Choudhry, None; Amani Fawzi, None; Allen Ho, None; Jean-Pierre Hubschman, None; Marion Munk, None; Robert Sergott, None; Eduardo Souza, None; David Sarraf, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5926. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Xuejing Chen, Ehsan Rahimy, Netan Choudhry, Amani A Fawzi, Allen C Ho, Jean-Pierre Hubschman, Marion Ronit Munk, Robert Sergott, Eduardo Cunha Souza, David Sarraf; Spectrum of Retinal Vascular Diseases Associated with Paracentral Middle Maculopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5926. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

Paracentral middle maculopathy (PAMM) is a newly described hyper-reflective, parafoveal band at the level of the inner nuclear layer (INL) on spectral domain optical coherence tomography (SD-OCT) that co-localizes with the intermediate (ICP) and deep capillary plexuses (DCP). This is an observational, retrospective, multi-centered case series to evaluate the spectrum of retinal diseases that demonstrate PAMM.

 
Methods
 

Nine patients (10 eyes) from 4 centers with PAMM lesions and associated retinal vascular diseases are included. Clinical presentations and multimodal imaging, including color photographs, near infrared reflectance, fluorescein angiography, SD-OCT, and color doppler imaging are described. Baseline and follow-up findings are correlated with demographics and systemic associations.

 
Results
 

PAMM lesions are verified by SD-OCT at baseline presentation in 5 men and 4 women (age 27 to 66 years). Follow-up SD-OCT analysis of these PAMM lesions demonstrated subsequent thinning of the INL. Novel systemic associations between retinal vasculopathy and PAMM include eye compression injury causing global ocular ischemia, sickle cell crisis, Purtscher’s retinopathy, occlusive retinal vasculitis, post-H1N1 vaccine, hypertensive retinopathy, migraine disorder, and post-upper respiratory infection.

 
Conclusions
 

PAMM lesions may develop in a wide spectrum of retinal vascular diseases. They are best identified with SD-OCT and may represent ischemia of the ICP and DCP. These lesions typically result in permanent thinning of the INL and are critical to identify in order to determine the cause of unexplained vision loss.  

 
Case 1: Prolonged globe compression leading to severe compromise in CRA and PCA blood flow as measured by color doppler imaging leading to PAMM. At baseline presentation, the flow for the CRA, NPCA, TPCA are severely reduced. Upon follow up, there was improved flow for each, except the NPCA OD, corresponding to slow reperfusion after relief of extended orbital pressure. OD: right; OS: left; CRA: central retinal artery; PCA: posterior cilary artery; NPCA: nasal PCA; TPCA: temporal PCA; OA: ophthalmic artery
 
Case 1: Prolonged globe compression leading to severe compromise in CRA and PCA blood flow as measured by color doppler imaging leading to PAMM. At baseline presentation, the flow for the CRA, NPCA, TPCA are severely reduced. Upon follow up, there was improved flow for each, except the NPCA OD, corresponding to slow reperfusion after relief of extended orbital pressure. OD: right; OS: left; CRA: central retinal artery; PCA: posterior cilary artery; NPCA: nasal PCA; TPCA: temporal PCA; OA: ophthalmic artery
 
 
Cases 2-9. F:female; M:male; OD:right; OS:left; OU:bilateral, CF:count fingers; BRAO:branch retinal artery occlusion; DVT:deep vein thrombosis, GI:gastrointestinal; OCP:oral contraceptive pills; HTN:hypertension; CHF:congestive heart failure; DM:diabetes mellitus; URI:upper respiratory infection
 
Cases 2-9. F:female; M:male; OD:right; OS:left; OU:bilateral, CF:count fingers; BRAO:branch retinal artery occlusion; DVT:deep vein thrombosis, GI:gastrointestinal; OCP:oral contraceptive pills; HTN:hypertension; CHF:congestive heart failure; DM:diabetes mellitus; URI:upper respiratory infection

 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×