RETINAL MICROVASCULATURE ALTERATION IN PARACENTRAL ACUTE MIDDLE MACULOPATHY AND ACUTE MACULAR NEURORETINOPATHY

Abstract

To present a series of idiopathic paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) cases and to compare the microvascular retinal status of PAMM/AMN eyes with those of healthy individuals. Six eyes with PAMM and two eyes with AMN in a total of six patients were included in this study. Multimodal retinal imaging, including optical coherence tomography angiography, was performed in all patients. The vessel density of the superficial capillary plexus and deep capillary plexus, as well as the area, circularity, and angle of the superficial foveal avascular zone (FAZ) were measured and compared with the same parameters in age-matched healthy individuals. The optical coherence tomography angiography showed a decreased vessel density of both superficial capillary plexus and deep capillary plexus in PAMM/AMN eyes versus control eyes (12.2 ± 0.74 vs. 14.0 ± 1.62 mm [P = 0.01] in superficial capillary plexus and 18.5 ± 1.2 vs. 20.2 ± 1.0 mm [P = 0.02] in deep capillary plexus). There was no statistically significant change in the FAZ area between PAMM/AMN and healthy eyes. However, FAZ circularity in PAMM/AMN eyes was statistically significantly lower compared with healthy eyes (0.64 ± 0.09 and 0.77 ± 0.07, respectively; P = 0.01). The angle of FAZ was statistically significantly higher in PAMM/AMN eyes compared with healthy eyes (27.6 ± 16.2 and 11.2 ± 5.5°, respectively; P = 0.005). Paracentral acute middle maculopathy and AMN eyes demonstrated not only an isolated alteration of deep retinal circulation but also general nonspecific changes in retinal microvasculature, including a decrease in the vessel density of the superficial capillary plexus and distortion of the FAZ.