Title

PARACENTRAL ACUTE MIDDLE MACULOPATHY: PRESENTATION AND OUTCOME.

Summary

Thirty-one-year-old master’s degree student presented at the ophthalmic emergency room complaining of a sudden painless scotoma in her left eye. Symptoms started at one hour earlier and kept stable. She denied any ocular or systemic disease, referred to regular use of combined oral contraceptive pills and caffeine abuse (five cups/day). Her best-corrected visual acuity was 20/20 in her right eye and 20/30 in her left eye. Pupils, applanation tonometry, and anterior segment biomicroscopy were unremarkable. The right eye fundus examination was unremarkable. Left eye fundus examination showed clear media, normal optic disc and a parafoveal region of retinal whitening, located one-disc diameter distant from the optic disc, and approximately a hundred micrometers from the foveal center. Ocular coherence tomography at the lesion topography demonstrated abnormal hyperreflective of the outer plexiform, inner nuclear, and inner plexiform layers. Microperimetry exhibited lower macular sensibility at the lesion topography (8 dB) compared to the normal adjacent retina (28 dB). We made the diagnoses of paracentral acute middle maculopathy, and the four month-follow-up recorded a progressive restore of the subjective visual acuity (returned to 20/20) and retinal sensitivity at the microperimetry (increased to 22 dB) despite the inner-nuclear-layer atrophy at the OCT.

Area

CLINICAL CASE

Authors

Leandro Jerez Chaves, Amanda Schnorr, Tomás Teixeira Pinto, Rodrigo Jorge