Idiopathic Paracentral Acute Middle Maculopathy in a Healthy Pregnant Woman: A Case Report

The purpose of this study is to report a case of idiopathic paracentral acute middle maculopathy (PAMM) in a healthy woman during the first trimester of an uncomplicated pregnancy.

A 28-year-old woman at 14 weeks gestation presented with sudden onset of a paracentral scotoma in her right eye. Although her best-corrected visual acuity remained 20/20 OU, dilated fundus examination, optical coherence tomography (OCT), and OCT angiography (OCTA) revealed paracentral acute middle maculopathy. A comprehensive systemic workup returned normal results, suggesting no underlying general condition. Over 1 year of follow-up, resolution of fundus and OCT findings, a gradual increase in deep-plexus vessel density in the affected area on OCTA was observed, and improvement in the patient's visual field was noted.

Despite its low incidence, PAMM should be included in the differential diagnosis of acute visual disturbances in pregnant women-even when no other risk factors are present. OCTA can be a valuable modality for both diagnosis and monitoring of PAMM.