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Updated: Aug 17, 2026
Multifocal Electroretinograms
Published on: December 4, 2011
PARACENTRAL ACUTE MIDDLE MACULOPATHY IN A PATIENT WITH FREQUENT MIGRAINE WITH AURA: A CASE REPORT
Vijaya R Dasari1, Ananth Selliyan2, Sean M Gratton2,3
1University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
Background/Purpose:
To explore the possible relationship between Paracentral Acute Middle Maculopathy (PAMM) and migraine. Paracentral acute middle maculopathy is a recently described clinical and optical coherence tomography entity involving infarction of the inner nuclear layer secondary to deep retinal capillary ischemia. It presents as a painless paracentral scotoma and often results in permanent visual deficits. Migraine, especially migraine with aura, has been shown to cause structural changes in the retinal microvasculature and to be a risk factor for retinal ischemia.
Methods:
A case report and review of the literature.
Results:
A 39-year-old woman with migraine with visual aura presented with a discrete, monocular, painless "buffalo-shaped" paracentral scotoma, which started during a period of frequent typical visual auras. Her exam and optical coherence tomography were consistent with PAMM.
Conclusion:
We propose that migraine is a risk factor for the development of PAMM. The changes in retinal microvasculature in migraine may increase a patient's susceptibility to retinal ischemia. Other risk factors for retinal ischemia, including diabetes, hypertension, hyperlipidemia, sickle cell disease, and orbital trauma, have been shown to be associated with PAMM. Further research should be conducted to determine whether there is a definite relationship between migraine and PAMM.
Insights
Migraine may be a risk factor for Paracentral Acute Middle Maculopathy (PAMM), a condition causing vision loss due to retinal ischemia. Further research is needed to confirm this link between migraine and PAMM.
Area of Science:
- Ophthalmology
- Neurology
- Retinal Vascular Diseases
Background:
- Paracentral Acute Middle Maculopathy (PAMM) is a recently identified condition characterized by inner nuclear layer infarction due to deep retinal capillary ischemia.
- PAMM can lead to significant and permanent visual deficits.
- Migraine, particularly migraine with aura, is known to affect retinal microvasculature and is a potential risk factor for retinal ischemia.
Observation:
- A case report details a 39-year-old woman experiencing migraine with visual aura.
Findings:
- The patient presented with a painless, monocular, paracentral scotoma, described as "buffalo-shaped," coinciding with frequent visual auras.
- Clinical examination and optical coherence tomography findings were consistent with PAMM.
Implications:
- This case suggests a potential association between migraine and the development of PAMM.
- Migraine-induced retinal microvascular changes may predispose individuals to retinal ischemia.
- Further investigation is warranted to establish a definitive relationship between migraine and PAMM, considering other known risk factors for retinal ischemia.
