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Paracentral acute middle maculopathy : case report and literature review

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Detalhes bibliográficos
Resumo:Purpose: Paracentral acute middle maculopathy (PAMM) refers to retinal lesions with changes in the inner nuclear layer (INL) on spectral-domain optic coherence tomography (SD-OCT), being a tomographic finding of deep retinal ischemia. PAMM is associated with retinal vascular pathology. We report a case of PAMM, using a multimodal imaging approach. Methods: Case report and literature review. Ophthalmic examination and imaging study with near infrared reflectance (NIR), fundus autofluorescence (FAF) and SD-OCT were performed. Results: A 13-year-old female presented with an acute paracentral scotoma of the right eye with a respective paracentral lesion hyporreflective on NIR and hypoautofluorescent. SD-OCT showed a hyperreflective band in the INL. At one-month, there was resolution of the paracentral scotoma and of the lesion in FAF, attenuation in NIR and subsequent INL thinning in SD-OCT. The patient did not present cardiovascular risk factors. Conclusions: This case shows the importance of being suspicious of PAMM when faced with nonspecific visual complaints with a normal examination. This clinical finding should be considered a complication of a retinal vasculopathy or systemic disease, possibly being the only sign to its presence. The recognition of PAMM should prompt an appropriate evaluation and investigation. In the absence of associated disease, PAMM might be considered idiopathic.
Autores principais:Sarmento, Tiago Maria Tavares Morais, 1992-
Assunto:Maculopatia média aguda paracentral Retina Oftalmologia
Ano:2016
País:Portugal
Tipo de documento:dissertação de mestrado
Tipo de acesso:acesso aberto
Instituição associada:Universidade de Lisboa
Idioma:inglês
Origem:Repositório da Universidade de Lisboa
Descrição
Resumo:Purpose: Paracentral acute middle maculopathy (PAMM) refers to retinal lesions with changes in the inner nuclear layer (INL) on spectral-domain optic coherence tomography (SD-OCT), being a tomographic finding of deep retinal ischemia. PAMM is associated with retinal vascular pathology. We report a case of PAMM, using a multimodal imaging approach. Methods: Case report and literature review. Ophthalmic examination and imaging study with near infrared reflectance (NIR), fundus autofluorescence (FAF) and SD-OCT were performed. Results: A 13-year-old female presented with an acute paracentral scotoma of the right eye with a respective paracentral lesion hyporreflective on NIR and hypoautofluorescent. SD-OCT showed a hyperreflective band in the INL. At one-month, there was resolution of the paracentral scotoma and of the lesion in FAF, attenuation in NIR and subsequent INL thinning in SD-OCT. The patient did not present cardiovascular risk factors. Conclusions: This case shows the importance of being suspicious of PAMM when faced with nonspecific visual complaints with a normal examination. This clinical finding should be considered a complication of a retinal vasculopathy or systemic disease, possibly being the only sign to its presence. The recognition of PAMM should prompt an appropriate evaluation and investigation. In the absence of associated disease, PAMM might be considered idiopathic.