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Functional and structural evolution of paracentral acute middle maculopathy

Published:February 08, 2021DOI:https://doi.org/10.1016/j.jcjo.2021.01.014
      A 22-year-old healthy man awoke with a new paracentral scotoma affecting his left eye. On examination, visual acuity was 20/20 in the left eye. Microperimetry (MP) showed reduced retinal sensitivity co-localized to a characteristic band of inner nuclear layer (INL) hyperreflectivity on optical coherence tomography representing paracentral acute middle maculopathy (PAMM) (Fig. 1, upper row). Weekly assessments documented the evolution of the PAMM lesion (Fig. 1). The scotoma persisted despite some improvement in the size with MP while sequential tracked optical coherence tomography B-scans illustrated a progressive decrease in reflectivity and thickness of the corresponding INL. The persistent scotoma of PAMM is the invariable outcome after a localized vascular insult causing INL infarction.
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