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High Frequency of Paracentral Acute Middle Maculopathy among symptomatic post-cardiac surgery patients
Lia Agliati1,2, Lorenzo Ferro Desideri1,2, Felicitas Mayer1,2
1Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, Bern CH-3010, Switzerland.
Purpose:
To investigate the incidence, clinical presentation, optical coherence tomography (OCT) features, and visual outcomes of paracentral acute middle maculopathy (PAMM) in patients presenting with visual symptoms after cardiac surgery.
Methods:
Retrospective observational study of patients who developed new visual symptoms after cardiac surgery and underwent ophthalmologic consultation at a tertiary referral center within 6 weeks from surgery. Collected data included visual symptoms, best-corrected visual acuity (BCVA), and OCT features.
Results:
Among 67 patients evaluated, 16 (23.9%) were diagnosed with PAMM. Mean age was 64.6 ± 10.8 years. Paracentral scotomas were reported in 31% of patients, while other frequently reported symptoms included photopsia (53%), floaters (38%), and blurred vision (25%). Cotton wool spots and retinal ischemic perivascular lesions were observed in 43.8% and 25% of patients, respectively. Among patients with available follow-up (n = 10), mean BCVA improved from 20/34 (logMAR 0.23) at presentation to 20/20 (logMAR 0.00) at last follow-up (p = 0.021).
Conclusions:
PAMM is a frequent finding in patients with visual symptoms after cardiac surgery, reflecting a substantial burden of retinal microvascular ischemia in this high-risk population. OCT enables identification of retinal microvascular ischemia despite often preserved visual acuity.
