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Area of Science:

  • Ophthalmology
  • Retinal Imaging
  • Macular Diseases

Background:

  • Paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) are distinct macular conditions.
  • Co-occurrence of PAMM and AMN in the same eye is rare and its underlying pathophysiology requires further investigation.

Purpose of the Study:

  • To analyze the imaging characteristics and clinical course of patients with coincident PAMM and AMN lesions in the same eye.
  • To explore potential shared pathophysiological mechanisms between PAMM and AMN.

Main Methods:

  • Retrospective, observational case series.
  • Multimodal imaging, including optical coherence tomography (OCT), was used to evaluate lesions.
  • Association with ocular and systemic findings was investigated.

Main Results:

  • Fifteen subjects (17 eyes) with coincident PAMM and AMN were analyzed.
  • Lesions were associated with various conditions including retinal vein occlusion and Purtscher's retinopathy.
  • Optical coherence tomography (OCT) revealed Z-shaped hyperreflective bands in Henle's fiber layer in 64.7% of affected eyes.

Conclusions:

  • Coincident PAMM and AMN suggest a common pathophysiological origin.
  • Retinal vein impairment and hypoperfusion of the deep retinal capillary plexus may underlie these conditions.
  • Injury to Müller glia or photoreceptors in Henle's fiber layer is a potential consequence.