PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH SEVERE PLASMODIUM FALCIPARUM MALARIA.

Abstract

To report a case of bilateral paracentral acute middle maculopathy (PAMM) lesions on spectral domain-optical coherence tomography (SD-OCT) secondary to severe Plasmodium falciparum malaria. Retrospective case report. SD-OCT, ultra-widefield fluorescein angiography, and OCT-angiography were performed and analysed. A 54-year-old healthy man presented with acute vision loss in both eyes few days after being diagnosed with severe Plasmodium falciparum malaria. Ophthalmoscopic examination was unremarkable but near-infrared reflectance imaging showed patchy hyporeflective areas located at the terminal tips of the venous branches. Corresponding SD-OCT demonstrated alternating bands of hyperreflectivity involving the inner nuclear layer and consistent with skip PAMM lesions. OCT-angiography illustrated corresponding flow signal loss at the level of the deep capillary plexus. Ultra-widefield fluorescein angiography showed peripheral retinal vein staining and capillary non-perfusion. PAMM may be an OCT manifestation of malaria retinopathy associated with severe Plasmodium falciparum infection.