Exploring Patient Demographics and Presence of Retinal Vascular Disease in Paracentral Acute Middle Maculopathy

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PurposeTo investigate the sociodemographic profile, the association with retinal vascular diseases (RVD) and systemic comorbidities, and visual outcomes of patients with paracentral acute middle maculopathy (PAMM) in a large, ethnically diverse single-center cohort. DesignRetrospective cohort study. MethodsElectronic health record query for all patients presenting with PAMM at Moorfields Eye Hospital, London, was completed. Detailed demographics, clinical and systemic information were collected and analyzed. ResultsA total of 78 eyes of 78 patients with confirmed PAMM were included in the study. 40 patients(51.3%) presented with no RVD, 20 patients(25.6%) with retinal vein occlusion(RVO), 16 patients(20.5%) with retinal artery occlusion(RAO), and two patients(2.6%) with concomitant RAO and RVO. Patients with PAMM+RAO were older than those with RVO(p=0.02) and more likely to have a history of major adverse cardiovascular events(MACE)(p=0.01), with a significantly worse presenting best corrected visual acuity (BCVA)(20/50) compared to patients with RVO (p=0.02) and no RVD (p<0.001). Individuals with isolated PAMM had a significantly higher prevalence of previous MACE (p=0.04) and sickle cell disease (SCD) (p=0.04) compared to those with RVO. At the last follow-up, 64 patients (85.3%) had a good BCVA (>20/32). ConclusionsThe significant association of PAMM with RVD supports the hypothesis of an ischemic etiology. Individuals with isolated PAMM had a higher prevalence of MACE and SCD. Thus, it is important to prompt immediate referral for a comprehensive systemic evaluation. Across the whole cohort, PAMM was associated with good BCVA improvement during follow-up, indicating a good visual prognosis.