|Year : 2022 | Volume
| Issue : 4 | Page : 1006
Paracentral acute middle maculopathy as a presenting feature of idiopathic intracranial hypertension
Ramanuj Samanta, Gitanjli Sood, Sreeram Jayaraj, Jyoti Kumari, Neha Preet, Ajai Agrawal
Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
|Date of Web Publication||11-Oct-2022|
Dr. Ramanuj Samanta
Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh - 249203, Uttarakhand
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Samanta R, Sood G, Jayaraj S, Kumari J, Preet N, Agrawal A. Paracentral acute middle maculopathy as a presenting feature of idiopathic intracranial hypertension. Indian J Ophthalmol Case Rep 2022;2:1006
|How to cite this URL:|
Samanta R, Sood G, Jayaraj S, Kumari J, Preet N, Agrawal A. Paracentral acute middle maculopathy as a presenting feature of idiopathic intracranial hypertension. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Dec 3];2:1006. Available from: https://www.ijoreports.in/text.asp?2022/2/4/1006/358144
A 21-year-old female presented with right eye (RE) acute paracentral scotoma of 10 days duration and headache of 2 months duration. The best-corrected visual acuity was 20/40 in RE and 20/20 in the left eye. Fundus [Figure 1]a revealed bilateral disk edema and paracentral acute middle maculopathy (PAMM) [Figure 1]b in the RE. Neurology review, cerebrospinal fluid (CSF) analysis, and neuroimaging revealed a diagnosis of idiopathic intracranial hypertension (IIH). Oral acetazolamide was started, and she was referred to the neurologist.
|Figure 1: Fundus photographs of both eyes (a) showing bilateral disk edema and a wedge-shaped area of retinal whitening in the right eye superonasal to fovea. Corresponding OCT (b) displaying placoid hyperreflective band-shaped area in inner nuclear layer (yellow arrows) and intact outer retinal layers, consistent with PAMM. OCT = optical coherence tomography, PAMM = paracentral acute middle maculopathy|
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Retinal manifestations in IIH include choroidal neovascularization, chorioretinal folds, macular exudate, venous stasis retinopathy, choroidal infarction, and branch retinal artery occlusion. Although PAMM is associated with various retinal conditions,, IIH-associated PAMM has only been reported in a single case report.
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