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Nitroglycerin as a Treatment Modality for Recurrent Isolated Paracentral Acute Middle Maculopathy: A Case Report

Jason K Sendek1, Anita Goyal2, Robert G Josephberg2

  • 1Ophthalmology, Briarcliff High School, Briarcliff Manor, USA.

Cureus
|December 27, 2021
PubMed

Insights

Sublingual nitroglycerin may rapidly resolve visual disturbances caused by paracentral acute middle maculopathy (PAMM). This case study suggests a potential new treatment for PAMM, a condition currently lacking therapeutic options.

Area of Science:

  • Ophthalmology
  • Vascular Biology
  • Retinal Imaging

Background:

  • Paracentral acute middle maculopathy (PAMM) involves ischemia of the macula's deep capillary plexus.
  • PAMM can cause paracentral visual scotomas and is associated with vascular conditions or occurs in healthy individuals.
  • Currently, no established treatments exist for PAMM.

Observation:

  • A male patient experienced recurrent episodes of PAMM, often linked to physical exertion or dehydration.
  • During a recent episode, the patient developed new visual scotomas in his right eye.
  • The patient had a history of PAMM in both eyes.

Findings:

  • Sublingual nitroglycerin was administered immediately after the onset of visual scotomas.
  • Nitroglycerin treatment led to rapid improvement in visual symptoms within minutes.
  • Complete resolution of visual symptoms occurred within hours of sublingual nitroglycerin administration.

Implications:

  • Sublingual nitroglycerin shows potential as a rapid-acting intervention for acute PAMM episodes.
  • This finding could offer a novel therapeutic approach for patients suffering from recurrent PAMM.
  • Further research is warranted to explore the efficacy and mechanisms of nitroglycerin in treating PAMM.
Keywords:
lesionnitroglycerinpammretinascotoma

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