Paracentral acute middle maculopathy spectraldomain optical coherence tomography feature of deep capillary ischemia

被引:87
作者
Rahimy, Ehsan [1 ]
Sarraf, David [2 ,3 ]
机构
[1] Thomas Jefferson Univ, Wills Eye Hosp, Retina Serv, Mid Atlantic Retina, Philadelphia, PA 19107 USA
[2] Univ Calif Los Angeles, Jules Stein Eye Inst, Los Angeles, CA 90095 USA
[3] Greater LA VA Healthcare Ctr, Los Angeles, CA USA
关键词
acute macular neuroretinopathy; deep capillary plexus; PAMM; SD-OCT; ACUTE MACULAR NEURORETINOPATHY; OXYGEN DISTRIBUTION; RETINAL OXYGEN; CONSUMPTION;
D O I
10.1097/ICU.0000000000000045
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose of ReviewTo describe the novel spectral-domain optical coherence tomography (SD-OCT) finding of paracentral acute middle maculopathy (PAMM) that can be associated with acute macular neuroretinopathy (AMN) or retinal vasculopathy, and that may indicate an underlying pathogenesis related to ischemia of the retinal deep capillary plexus (DCP).Recent FindingsWith the advent of high-definition SD-OCT imaging, we are now able to detect deep capillary ischemia. Although cotton wool spots are caused by ischemia of the superficial capillary plexus, PAMM is caused by ischemia of the DCP, and appears as hyper-reflective, band-like lesions in the middle retina, extending from the inner nuclear layer (INL)/outer plexiform layer junction to involve the full-thickness INL. Over time, these lesions resolve with atrophy of the INL, resulting in persistent paracentral scotomas for the patient. Originally, PAMM was identified in isolation and thus classified into a subcategory of AMN. Subsequent reports have demonstrated PAMM lesions in the setting of coexisting retinal vascular disease, notably nonproliferative diabetic retinopathy and central retinal vein occlusion.SummaryPAMM refers to a recently described class of characteristic SD-OCT lesions involving the middle layers of the retina at the level of the INL. If a patient presenting with PAMM is young and healthy without any other vascular disease, this may represent a novel variant of AMN. However, if the patient has an underlying retinal vascular disease, such as diabetic retinopathy or retinal vascular occlusion, one would refer to the lesion as PAMM complicating the underlying retinal vascular disease.
引用
收藏
页码:207 / 212
页数:6
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