Optical Coherence Tomography Angiography of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy

Acute macular neuroretinopathy: pathogenetic insights from optical coherence tomography angiography

“…Unlike AMN, PAMM is nowadays not considered a distinct disease but a clinical finding which may be either idiopathic or secondary to several retinal vascular disorders and systemic conditions 14. Subsequent studies using OCT-A confirmed the findings of Pecen et al 13 by showing that PAMM is a manifestation of focal ischaemia of the deep retinal circulation 15…”

“…Pecen et al 13 were the first to report DCP flow void on OCT-A in a pregnant woman who was reported to have ‘AMN/paracentral acute middle maculopathy (PAMM)’ presenting with paracentral scotoma and OCT hyper-reflective bands in the middle retinal layers with rather unaffected photoreceptor layers 13…”

The fundus photo has met its match: optical coherence tomography and adaptive optics ophthalmoscopy are here to stay

“…Optical coherence tomography angiography has also been used to evaluate blood vessel perfusion in numerous retinal and ONH conditions including: subretinal fibrosis, macular telangiectasia, idiopathic CNV, punctate inner choroidopathy, polypoidal choroidal vasculopathy, polypoidal choroidal neovascularisation, pachychoroid neovasculopathy, sickle cell maculopathy, retinal vein occlusion, retinal artery occlusion, acute macular neuroretinopathy and paracentral acute middle maculopathy, type 2 retinal arteriovenous malformation, radiation retinopathy, ocular toxoplasmosis, central serous chorioretinopathy, choroideremia, birdshot chorioretinopathy ( Figure ), hyperoxia, and multiple sclerosis, and glaucoma. In open angle glaucoma, OCT angiography showed reduced vessel flow and density in the optic disk compared to normal, which correlated with glaucoma severity .…”

The OCT Angiography Revolution: 5 Emerging Themes

“…10 Other conditions, such as macular telangiectasia type 2 (MacTel2) and paracentral acute middle maculopathy (PAMM) have very characteristic findings on OCTA suggesting its role as a mainstay in diagnosis of these conditions. 11, 12 In both of these conditions, the value of the depth-resolved nature of OCTA is particularly apparent. For PAMM, previous studies had strongly suggested the underlying pathophysiology was an infarct of the inner nuclear layer, but the depth-resolved vascular flow information provided through OCTA provides clear evidence of this hypothesis through hypoperfusion of the deep capillary retinal plexus.…”

“…For PAMM, previous studies had strongly suggested the underlying pathophysiology was an infarct of the inner nuclear layer, but the depth-resolved vascular flow information provided through OCTA provides clear evidence of this hypothesis through hypoperfusion of the deep capillary retinal plexus. 12 For MacTel2, some of the earliest changes are subtle alterations in the temporal parafoveal deep capillary plexus. 11 OCTA easily visualizes these alterations and also functions as an excellent surveillance tool for underlying CNV.…”