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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
PARACENTRAL ACUTE MIDDLE MACULOPATHY IN GIANT CELL ARTERITIS
Francesco Pellegrini1, Kevin Mairot2, Alessandra Cuna3
1Ophthalmology Department, "Santa Maria degli Angeli" Hospital, Pordenone (PN), Italy.
Purpose:
To describe a representative case and review the literature on paracentral acute middle maculopathy (PAMM) and giant cell arteritis (GCA).
Methods:
A review of the English-language ophthalmic literature was performed using the search terms of PAMM, giant cell arteritis, and temporal arteritis.
Results:
A 72-year-old woman with PAMM as the presenting ophthalmic manifestation of GCA was described with a review of the prior cases from the literature. It was found that there were 26 cases of PAMM in GCA. In 19 of 26 cases, PAMM was associated with no other fundus abnormalities and was only seen on multimodal imaging including optical coherence tomography.
Conclusion:
PAMM can cause acute paracentral visual loss, and GCA should be suspected in all cases of PAMM of the elderly patients, even when isolated and not associated with constitutional symptoms of GCA.
Insights
Giant cell arteritis (GCA) can present as paracentral acute middle maculopathy (PAMM), causing vision loss. Suspect GCA in elderly patients with PAMM, even without typical symptoms.
Area of Science:
- Ophthalmology
- Rheumatology
Background:
- Paracentral acute middle maculopathy (PAMM) is a condition causing visual disturbances.
- Giant cell arteritis (GCA) is a systemic vasculitis affecting medium and large arteries.
Purpose of the Study:
- To describe a case of PAMM as an initial manifestation of GCA.
- To review the literature on the association between PAMM and GCA.
Main Methods:
- Literature review of English-language ophthalmic studies.
- Search terms included PAMM, giant cell arteritis, and temporal arteritis.
Main Results:
- A case of a 72-year-old woman with PAMM as the presenting sign of GCA was detailed.
- 26 cases of PAMM associated with GCA were identified in the literature.
- In 19 of these cases, PAMM was the sole fundus abnormality, detected via multimodal imaging.
Conclusions:
- PAMM can lead to acute paracentral vision loss.
- GCA should be considered in elderly patients presenting with PAMM, irrespective of constitutional symptoms.
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