Paracentral acute middle maculopathy immediately following internal carotid endovascular repair
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Abstract
Paracentral acute middle maculopathy (PAMM) can result from decreased perfusion to retinal and choroidal circulations meeting in the inner nuclear layer (INL) and outer plexiform layer (OPL). Although ischemia in these layers is rare, certain procedures place patients at risk for possible events, such as cardiopulmonary bypass, coronary angiography, and endovascular coil embolization. We report the case of a 70-year-old woman with a sudden-onset left paracentral scotoma following internal carotid endovascular repair. Currently no treatment or preventive technique is available. Additional ischemic events can occur if a preventable cause is not identified.
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References
Sarraf D, Rahimy E, Fawzi AA, et al. Paracentral acute middle maculopathy: a new variant of acute macular neuroretinopathy associated with retinal capillary ischemia. JAMA Ophthalmol 2013;131:1275-87. DOI: https://doi.org/10.1001/jamaophthalmol.2013.4056
Moura-Coelho N, Gaspar T, Ferreira JT, et al. Paracentral acute middle maculopathy—review of the literature. Graefes Arch Clin Exp Ophthalmol 2020;258:2583-96. DOI: https://doi.org/10.1007/s00417-020-04826-1
Rahimy E, Kuehlewein L, Sadda SR, Sarraf D. Paracentral acute middle maculopathy: what we knew then and what we know now. Retina 2015;35:1921-30. DOI: https://doi.org/10.1097/IAE.0000000000000785
Lando L, Isaac DLC, Avila MP. Paracentral acute middle maculopathy after aortic aneurysm repair. Retin Cases Brief Rep 2022;16:177-9. DOI: https://doi.org/10.1097/ICB.0000000000000927
Nakamura M, Katagiri S, Hayashi T, et al. Paracentral acute middle maculopathy after endovascular coil embolization. Retin Cases Brief Rep 2021;15:281-5. DOI: https://doi.org/10.1097/ICB.0000000000000784
Schmitt KJ, Agrawal R, Adrean SD. Paracentral acute middle maculopathy following coronary angiography. Am J Ophthalmol Case Rep 2022;28:101674. DOI: https://doi.org/10.1016/j.ajoc.2022.101674
Elwood KF, Wong RW. Paracentral acute middle maculopathy after preworkout Havok ingestion. Retin Cases Brief Rep. Epub ahead of print. Published online March 8, 2018. doi: 10.1097/ICB.0000000000000739. DOI: https://doi.org/10.1097/ICB.0000000000000739
Michalak SM, Mukherjee N, Gospe SM 3rd. Bilateral paracentral acute middle maculopathy after cardiopulmonary bypass. Retin Cases Brief Rep 2022;16:285-8. DOI: https://doi.org/10.1097/ICB.0000000000000982
Campbell JP, Zhang M, Hwang TS, et al. Detailed vascular anatomy of the human retina by projection-resolved optical coherence tomography angiography. Sci Rep 2017;7:42201. DOI: https://doi.org/10.1038/srep42201
Scharf J, Freund KB, Sadda S, Sarraf D. Paracentral acute middle maculopathy and the organization of the retinal capillary plexuses. Prog Retin Eye Res 2021;81:100884. DOI: https://doi.org/10.1016/j.preteyeres.2020.100884
Nakamura M, Katagiri S, Hayashi T, et al. Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy. Int Med Case Rep J 2019;12:143-9. DOI: https://doi.org/10.2147/IMCRJ.S196047
Briganti F, Leone G, Marseglia M, et al. Endovascular treatment of cerebral aneurysms using flow-diverter devices: a systematic review. Neuroradiol J 2015;28:365-75. DOI: https://doi.org/10.1177/1971400915602803
Fogel-Levin M, Sadda SR, Rosenfeld PJ, et al. Advanced retinal imaging and applications for clinical practice: a consensus review. Surv Ophthalmol 2022;67:1373-90. DOI: https://doi.org/10.1016/j.survophthal.2022.02.004
Bakhoum MF, Freund KB, Dolz-Marco R, et al. Paracentral acute middle maculopathy and the ischemic cascade associated with retinal vascular occlusion. Am J Ophthalmol 2018;195:143-53. DOI: https://doi.org/10.1016/j.ajo.2018.07.031
Ghasemi Falavarjani K, Phasukkijwatana N, Freund KB, et al. En face optical coherence tomography analysis to assess the spectrum of perivenular ischemia and paracentral acute middle maculopathy in retinal vein occlusion. Am J Ophthalmol 2017;177:131-8. DOI: https://doi.org/10.1016/j.ajo.2017.02.015