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Association of Chronic Paracentral Acute Middle Maculopathy Lesions with Hypertension

Maria A Burnasheva1, Dmitrii S Maltsev1, Alexei N Kulikov1

  • 1Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia.

Ophthalmology. Retina
|January 18, 2020
PubMed
Abstract

Insights

Mild hypertension significantly increases the risk of chronic paracentral acute middle maculopathy (PAMM) lesions. These PAMM lesions appear to be an early indicator of retinal microcirculation changes in hypertensive patients.

Area of Science:

  • Ophthalmology
  • Cardiovascular Research
  • Medical Imaging

Background:

  • Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases.
  • Retinal microcirculation changes can reflect systemic vascular health.
  • Paracentral acute middle maculopathy (PAMM) is a condition affecting the macula.

Purpose of the Study:

  • To investigate alterations in retinal microcirculation in patients with mild hypertension.
  • To determine the prevalence of chronic PAMM lesions in individuals with mild hypertension.

Main Methods:

  • A prospective cohort study comparing 27 patients with mild hypertension to 24 healthy controls.
  • Optical Coherence Tomography Angiography (OCTA) was used to assess foveal avascular zone (FAZ) area and vessel density in superficial and deep capillary plexuses (SCP and DCP).
  • Chronic PAMM lesions were identified by analyzing cross-sectional OCT images for specific retinal layer thinning and disruption.

Main Results:

  • No significant differences were observed in FAZ area or vessel density (SCP and DCP) between hypertensive patients and healthy controls.
  • Chronic PAMM lesions were found in 88.9% of hypertensive patients compared to 16.7% of healthy individuals.
  • Patients with mild hypertension had a 40-fold increased odds ratio for the presence of chronic PAMM lesions (P < 0.001).

Conclusions:

  • Chronic PAMM lesions are highly prevalent in patients with mild hypertension.
  • These lesions may serve as an early sign of retinal microcirculatory damage in mild hypertension, preceding detectable changes in OCTA parameters.
  • Further research is warranted to understand the clinical implications and progression of PAMM in hypertensive individuals.

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