Paracentral Acute Middle Maculopathy as a Specific Sign of Arteritic Anterior Ischemic Optic Neuropathy

center dot PURPOSE: The purpose of this study is to assess the di-agnostic accuracy of paracentral acute middle maculopa-thy (PAMM) in the setting of anterior ischemic optic neu-ropathy (AION) to distinguish arteritic (A-AION) from nonarteritic (NA-AION) type. center dot DESIGN: Retrospective cross-sectional diagnostic eval-uation. center dot METHODS: PAMM was evaluated by 3 physicians blinded to diagnosis using macular spectral-domain opti-cal coherence tomography. We studied 45 patients with AION. Of those, 28 had NA-AION and 17 had A-AION. The study was conducted in the Department of Ophthalmology at the Hospital of Marseille-Assistance Publique, France, from January 1, 2018, to March 31, 2022. center dot RESULTS: PAMM were only found in the A-AION group (N = 4) ( P = .0143). As a distinctive sign of A-AION, we found a specificity of 100% (95% IC, 88.06%-100%) and a positive predictive value of 100%. In contrast, sensitivity and negative predictive value were lower, 19.1% (95% IC, 5.5-42.0) and 63.0% (95% CI, 58.1-67.7), respectively. center dot CONCLUSIONS: The PAMM finding is highly specific for A-AION in the setting of AION. According to our results, macular spectral-domain optical coherence to-mography looking for PAMM should be performed with any patient presenting with AION. (Am J Ophthal-mol 2023;248: 1-7. (c) 2022 Elsevier Inc. All rights re-served.)