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OPHTHALMIC IMAGE
Year : 2022  |  Volume : 2  |  Issue : 4  |  Page : 1006

Paracentral acute middle maculopathy as a presenting feature of idiopathic intracranial hypertension


Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India

Date of Web Publication11-Oct-2022

Correspondence Address:
Dr. Ramanuj Samanta
Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh - 249203, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1079_22

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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.[1] Although PAMM is associated with various retinal conditions,[2],[3] IIH-associated PAMM has only been reported in a single case report.[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Nichani P, Micieli JA. Retinal Manifestations of Idiopathic Intracranial Hypertension. Ophthalmol Retina 2021;5:429-37.  Back to cited text no. 1
    
2.
Rahimy E, Kuehlewein L, Sadda SR, Sarraf D. Paracentral acute middle maculopathy: What we knew then and what we know now. Retina 2015;35:1921-30.  Back to cited text no. 2
    
3.
Chen X, Rahimy E, Sergott RC, Nunes RP, Souza EC, Choudhry N, et al. Spectrum of retinal vascular diseases associated with paracentral acute middle maculopathy. Am J Ophthalmol 2015;160:26-34.  Back to cited text no. 3
    
4.
Denny MR, Kalevar A, Chen JJ, Johnson RN. Paracentral acute middle maculopathy associated with idiopathic intracranial hypertension. Retin Cases Brief Rep 2021;15:540-2.  Back to cited text no. 4
    


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