Background: Paracentral acute macula maculopathy (PAMM) is a disease characterized by a hyperreflective band on optical coherence tomography (OCT), primarily in the inner nuclear layer (INL). The ischemia of capillary plexus is believed to be a cause of PAMM. In this report, we describe a patient with PAMM associated with transient retinal ischemia caused by central retinal artery occlusion whose blood flow signal was observable on OCT angiography (OCTA) over time.
Case report: A 47-year-old woman presented with vision loss in the right eye. At the first visit, frequent cotton wool spots in the right eye and delayed retinal circulation time in fluorescein angiography were observed, and OCT showed a hyperreflective INL around the macula. The patient was diagnosed with PAMM caused by retinal ischemia. The reduction of blood flow signals was observed in both the superficial and deep layers of the retina on the en-face image of OCTA. Four days later, although funduscopic findings and OCT showed no remarkable change, recovery of the flow signal in the superficial and deep capillary plexuses to baseline was observed on OCTA. One month later, the cotton wool spots on the fundus and hyperreflective findings of the inner nuclear layer observed on OCT disappeared, and thinning of INL was observed. The recovery of the flow signals on OCTA was maintained.
Conclusion: In the present case of PAMM associated with transient retinal ischemia, a transient decrease in the flow signals of retinal capillary on OCTA was observed; however, this transient decrease may improve to baseline in a short period of time.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 125: 732-737,2021.