Paracentral acute middle maculopathy in otherwise, young healthy female patients

The retina is supplied with blood through superficial and deep capillary systems. Paracentral acute middle maculopathy (PAMM) is a relatively new terminology based on pathognomonic findings in the spectral-domain optical coherence tomography (SD-OCT). A connection with various retinal vascular diseases has been described, which is indicative of an ischemic etiology. The objective of our study is to contribute to the understanding of PAMM as either an isolated phenomenon or one associated with underlying health issues. We hope to contribute to a better understanding of this medical condition for potential future clinical approaches.

This is a retrospective chart review performed at the Department of Ophthalmology of the Medical University of Graz. We reviewed the medical charts of patients who presented at our ophthalmological emergency department between January and April 2023. Patients with a diagnosis of PAMM, verified by a retina specialist, were included in our analysis.

Overall, five eyes of five female patients were enrolled. The patients' age averaged 28.6 ± 10.4 years (16-44), with a median visual acuity at the initial presentation of 0 logMAR (1.9-0). Multimodal imaging, including SD-OCT, OCT angiography, fluorescein angiography and fundus photography, was performed. A complete blood count and a comprehensive internal medicine examination were performed, yielding no underlying comorbidities.

Our study shows that isolated PAMM may occur as an idiopathic exclusion diagnosis in otherwise healthy adults after further investigation yielded no results. However, due to the potential vascular comorbidities shown in previous studies, a thorough investigation should still be carried out.