Bilateral Sequential Paracentral Acute Middle Maculopathy

We aim to present a case with bilateral sequential paracentral acute middle maculopathy (PAMM). A 57-year-old man presented with paracentral scotoma in the left eye. The patient's multimodal imaging findings were consistent with PAMM in the left eye. Extensive systemic work-up revealed hypertension and a history of cerebrovascular event. One year after initial presentation, the patient had a subsequent decrease in visual acuity in the right eye and developed optical coherence tomography findings consistent with PAMM, whereas the left eye showed resolved PAMM findings. Although rare, PAMM can occur bilaterally. Clinicians should monitor unilateral PAMM patients with systemic vasculopathy for involvement in the fellow eye.