PARACENTRAL ACUTE MIDDLE MACULOPATHY IN PREGNANCY

Area of Science:

• Ophthalmology
• Retinal Vascular Diseases
• Pregnancy Complications

Background:

• Paracentral acute middle maculopathy (PAMM) is an ischemic maculopathy affecting the outer retina.
• PAMM has been associated with retinal vascular disease and systemic vascular conditions.
• Pregnancy is not typically considered a direct risk factor for PAMM.

Observation:

• A 31-year-old woman presented with paracentral scotoma during her first trimester of pregnancy.
• Ocular examination revealed a classic acute PAMM lesion on optical coherence tomography.
• Optical coherence tomography angiography demonstrated preserved vascular flow within the PAMM lesion.

Findings:

• The patient had no other ocular or systemic comorbidities.
• Extensive workup for underlying systemic diseases affecting retinal vasculature yielded negative results.
• This represents the first reported case of PAMM solely associated with an uncomplicated pregnancy.

Implications:

• This case expands the known clinical spectrum of PAMM.
• It suggests that pregnancy, even without complications, may be an independent factor in PAMM development.
• Further research is warranted to understand the potential mechanisms linking pregnancy and PAMM.