PARACENTRAL ACUTE MIDDLE MACULOPATHY: A CHAMELEON MISSED

Abstract

Paracentral acute middle maculopathy (PAMM) represents a type of ischemic maculopathy. These lesions were associated with branch and central retinal arterial occlusion, central retinal vein occlusion (CRVO), diabetic retinopathy, sickle cell retinopathy, and Purtscher retinopathy. Flu-like illness, and transient orbital compression are the symptoms. A typical presentation is sudden onset paracentral scotomas with or without decreased vision, parafoveal greyish-white lesions, and on spectral domain optical coherence tomography (SD-OCT) shows hyperreflective bands localized to the middle layers of the retina, mainly the outer plexiform layer (OPL) and inner nuclear layer (INL). It is painless and sudden, mimicking optic neuritis and ischemic optic neuropathy. We present a patient with this rare disorder with its diagnostic challenges and management strategies.