Bilateral Sequential Paracentral Acute Middle Maculopathy

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Disease

Background:

• Paracentral acute middle maculopathy (PAMM) is an inner retinal finding.
• PAMM is typically unilateral, but bilateral cases are increasingly reported.

Observation:

• A 57-year-old male presented with unilateral paracentral vision loss.
• Multimodal imaging confirmed PAMM in the left eye.
• Systemic evaluation revealed hypertension and prior cerebrovascular event.

Findings:

• One year later, the patient developed decreased visual acuity in the right eye.
• Optical coherence tomography confirmed PAMM in the right eye, with resolution in the left.
• This case demonstrates sequential bilateral PAMM in a patient with systemic vasculopathy.

Implications:

• Bilateral sequential PAMM, though rare, can occur.
• Ophthalmologists should monitor patients with unilateral PAMM and systemic vasculopathy for potential fellow eye involvement.
• Early detection and monitoring are crucial for managing bilateral PAMM.