Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy
Masaki Nakamura,1 Satoshi Katagiri,1 Takaaki Hayashi,1,2 Ranko Aoyagi,1 Taiji Hasegawa,3 Akiko Kogure,3 Tomohiro Iida,3 Tadashi Nakano11Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, Katsushika Medical Center, The Jikei University Sc...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2019-05-01
|
Series: | International Medical Case Reports Journal |
Subjects: | |
Online Access: | https://www.dovepress.com/longitudinal-follow-up-of-two-patients-with-isolated-paracentral-acute-peer-reviewed-article-IMCRJ |
_version_ | 1819077082676723712 |
---|---|
author | Nakamura M Katagiri S Hayashi T Aoyagi R Hasegawa T Kogure A Iida T Nakano T |
author_facet | Nakamura M Katagiri S Hayashi T Aoyagi R Hasegawa T Kogure A Iida T Nakano T |
author_sort | Nakamura M |
collection | DOAJ |
description | Masaki Nakamura,1 Satoshi Katagiri,1 Takaaki Hayashi,1,2 Ranko Aoyagi,1 Taiji Hasegawa,3 Akiko Kogure,3 Tomohiro Iida,3 Tadashi Nakano11Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, Katsushika Medical Center, The Jikei University School of Medicine, Tokyo, Japan; 3Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo, JapanObjective: To describe longitudinal retinal changes in two cases of isolated paracentral acute middle maculopathy (PAMM).Case series: We reported two cases (64 and 67-year-old men) with isolated PAMM, who were followed-up for over 5 and 2.5 years, respectively. Both cases exhibited similar clinical natural histories. The first examinations took place several days after onset, with funduscopy showing that both cases exhibited paracentral scotoma with good visual acuity and small gray lesions, while optical coherence tomography (OCT) showed the presence of a hyperreflective band that ranged from the inner plexiform layer to the outer plexiform layer (OPL). The lesions became unremarkable within 1 month. The hyperreflective band also became unremarkable and was limited to the inner nuclear layer (INL) within 1 month, with the band disappearing within several months. Subsequently, OCT showed there was a thin and irregular INL and OPL, an excavated change of the inner retinal surface, along with outer nuclear layer (ONL) thickening. After several years, OCT angiography demonstrated normal flow of macular capillaries in the superficial capillary plexus, and decreased flow in the lesion with dilation of the capillaries around the area in the deep capillary plexus (DCP). Focal serous retinal detachment (SRD) occurred in one case after 4–5 years.Conclusion: Our findings indicated that long-term retinal changes in PAMM resulted in excavation of the inner retinal surface, INL thinning, ONL thickening and abnormal vasculature, especially in the DCP. Focal SRD may be a rare complication that can present at 4 years after onset.Keywords: paracentral acute middle maculopathy, optical coherence tomography angiography, serous retinal detachment |
first_indexed | 2024-12-21T18:51:33Z |
format | Article |
id | doaj.art-d0749d0d505141199a888706b27303a2 |
institution | Directory Open Access Journal |
issn | 1179-142X |
language | English |
last_indexed | 2024-12-21T18:51:33Z |
publishDate | 2019-05-01 |
publisher | Dove Medical Press |
record_format | Article |
series | International Medical Case Reports Journal |
spelling | doaj.art-d0749d0d505141199a888706b27303a22022-12-21T18:53:45ZengDove Medical PressInternational Medical Case Reports Journal1179-142X2019-05-01Volume 1214314945595Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathyNakamura MKatagiri SHayashi TAoyagi RHasegawa TKogure AIida TNakano TMasaki Nakamura,1 Satoshi Katagiri,1 Takaaki Hayashi,1,2 Ranko Aoyagi,1 Taiji Hasegawa,3 Akiko Kogure,3 Tomohiro Iida,3 Tadashi Nakano11Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, Katsushika Medical Center, The Jikei University School of Medicine, Tokyo, Japan; 3Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo, JapanObjective: To describe longitudinal retinal changes in two cases of isolated paracentral acute middle maculopathy (PAMM).Case series: We reported two cases (64 and 67-year-old men) with isolated PAMM, who were followed-up for over 5 and 2.5 years, respectively. Both cases exhibited similar clinical natural histories. The first examinations took place several days after onset, with funduscopy showing that both cases exhibited paracentral scotoma with good visual acuity and small gray lesions, while optical coherence tomography (OCT) showed the presence of a hyperreflective band that ranged from the inner plexiform layer to the outer plexiform layer (OPL). The lesions became unremarkable within 1 month. The hyperreflective band also became unremarkable and was limited to the inner nuclear layer (INL) within 1 month, with the band disappearing within several months. Subsequently, OCT showed there was a thin and irregular INL and OPL, an excavated change of the inner retinal surface, along with outer nuclear layer (ONL) thickening. After several years, OCT angiography demonstrated normal flow of macular capillaries in the superficial capillary plexus, and decreased flow in the lesion with dilation of the capillaries around the area in the deep capillary plexus (DCP). Focal serous retinal detachment (SRD) occurred in one case after 4–5 years.Conclusion: Our findings indicated that long-term retinal changes in PAMM resulted in excavation of the inner retinal surface, INL thinning, ONL thickening and abnormal vasculature, especially in the DCP. Focal SRD may be a rare complication that can present at 4 years after onset.Keywords: paracentral acute middle maculopathy, optical coherence tomography angiography, serous retinal detachmenthttps://www.dovepress.com/longitudinal-follow-up-of-two-patients-with-isolated-paracentral-acute-peer-reviewed-article-IMCRJparacentral acute middle maculopathyoptical coherence tomography angiographyserous retinal detachment |
spellingShingle | Nakamura M Katagiri S Hayashi T Aoyagi R Hasegawa T Kogure A Iida T Nakano T Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy International Medical Case Reports Journal paracentral acute middle maculopathy optical coherence tomography angiography serous retinal detachment |
title | Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy |
title_full | Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy |
title_fullStr | Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy |
title_full_unstemmed | Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy |
title_short | Longitudinal follow-up of two patients with isolated paracentral acute middle maculopathy |
title_sort | longitudinal follow up of two patients with isolated paracentral acute middle maculopathy |
topic | paracentral acute middle maculopathy optical coherence tomography angiography serous retinal detachment |
url | https://www.dovepress.com/longitudinal-follow-up-of-two-patients-with-isolated-paracentral-acute-peer-reviewed-article-IMCRJ |
work_keys_str_mv | AT nakamuram longitudinalfollowupoftwopatientswithisolatedparacentralacutemiddlemaculopathy AT katagiris longitudinalfollowupoftwopatientswithisolatedparacentralacutemiddlemaculopathy AT hayashit longitudinalfollowupoftwopatientswithisolatedparacentralacutemiddlemaculopathy AT aoyagir longitudinalfollowupoftwopatientswithisolatedparacentralacutemiddlemaculopathy AT hasegawat longitudinalfollowupoftwopatientswithisolatedparacentralacutemiddlemaculopathy AT kogurea longitudinalfollowupoftwopatientswithisolatedparacentralacutemiddlemaculopathy AT iidat longitudinalfollowupoftwopatientswithisolatedparacentralacutemiddlemaculopathy AT nakanot longitudinalfollowupoftwopatientswithisolatedparacentralacutemiddlemaculopathy |