BACKGROUND/ PURPOSE: To present a novel case of paracentral acute middle maculopathy associated with bilateral optic disk swelling. METHODS: Retrospective case report. RESULTS: A 67-year-old woman presented with sudden onset of central vision loss and subsequent bilateral optic disk edema, retinal vessel attenuation, and anterior uveitis. Cerebrospinal fluid analysis showed signs of inflammation. Spectral domain optical coherence tomography demonstrated the pathognomonic hyperreflectivity of the middle retinal layers consistent with paracentral acute middle maculopathy. Swept-source optical coherence tomography angiography with custom vessel analysis demonstrated a 18.3% decrease in the deep retinal vascular density and 2.4 times increase in absent flow area in the affected eye compared with the fellow eye. CONCLUSION: This case demonstrates a novel association between paracentral acute middle maculopathy and bilateral optic disk swelling secondary to central nervous system inflammation and possible infection. Although spectral domain optical coherence tomography is valuable in detecting paracentral acute middle maculopathy, optical coherence tomography angiography with vessel analysis can provide additional insight into the disease mechanism.
BACKGROUND/ PURPOSE: To present a novel case of paracentral acute middle maculopathy associated with bilateral optic disk swelling. METHODS: Retrospective case report. RESULTS: A 67-year-old woman presented with sudden onset of central vision loss and subsequent bilateral optic disk edema, retinal vessel attenuation, and anterior uveitis. Cerebrospinal fluid analysis showed signs of inflammation. Spectral domain optical coherence tomography demonstrated the pathognomonic hyperreflectivity of the middle retinal layers consistent with paracentral acute middle maculopathy. Swept-source optical coherence tomography angiography with custom vessel analysis demonstrated a 18.3% decrease in the deep retinal vascular density and 2.4 times increase in absent flow area in the affected eye compared with the fellow eye. CONCLUSION: This case demonstrates a novel association between paracentral acute middle maculopathy and bilateral optic disk swelling secondary to central nervous system inflammation and possible infection. Although spectral domain optical coherence tomography is valuable in detecting paracentral acute middle maculopathy, optical coherence tomography angiography with vessel analysis can provide additional insight into the disease mechanism.
Authors: Xuejing Chen; Ehsan Rahimy; Robert C Sergott; Renata P Nunes; Eduardo C Souza; Netan Choudhry; Nathan E Cutler; Samuel K S Houston; Marion R Munk; Amani A Fawzi; Sonia Mehta; Jean-Pierre Hubschman; Allen C Ho; David Sarraf Journal: Am J Ophthalmol Date: 2015-04-04 Impact factor: 5.258
Authors: Mona Parikh; Neil R Miller; Andrew G Lee; Peter J Savino; M Noel Vacarezza; Wayne Cornblath; Eric Eggenberger; Aileen Antonio-Santos; Karl Golnik; Randy Kardon; Michael Wall Journal: Ophthalmology Date: 2006-08-01 Impact factor: 12.079
Authors: David Sarraf; Ehsan Rahimy; Amani A Fawzi; Elliott Sohn; Irene Barbazetto; David N Zacks; Robert A Mittra; James M Klancnik; Sarah Mrejen; Naomi R Goldberg; Robert Beardsley; John A Sorenson; K Bailey Freund Journal: JAMA Ophthalmol Date: 2013-10 Impact factor: 7.389
Authors: Julia Nemiroff; Laura Kuehlewein; Ehsan Rahimy; Irena Tsui; Rishi Doshi; Alain Gaudric; Michael B Gorin; SriniVas Sadda; David Sarraf Journal: Am J Ophthalmol Date: 2015-11-10 Impact factor: 5.258