Widefield en face optical coherence tomography monitoring of the peri-venular fern-like pattern of paracentral acute middle maculopathy

Prashanth G. Iyer, Swarup S. Swaminathan, Omer Trivizki, Yingying Shi, Mengxi Shen, Mary Kansora, Giovanni Gregori, Philip J. Rosenfeld

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To demonstrate the ability of widefield en face swept source optical coherence tomography (OCT) imaging to monitor peri-venular fern-like patterns of paracentral acute middle maculopathy (PAMM) associated with retinal arterial occlusions. Observations: The peri-venular fern-like pattern of PAMM was diagnosed on the 12 × 12 mm en face structural OCT images from three patients. Fluorescein angiography images were unremarkable. Over time, all three patients demonstrated significant improvement in visual acuity with resolution of their peri-venular PAMM. Conclusions: The peri-venular fern-like pattern of PAMM is usually associated with retinal vein occlusions, but we identified three cases with this pattern in eyes with presumed incomplete retinal arterial occlusions. Our cases support the ischemic cascade theory that begins within the deep capillary plexus and ascends in the retina depending on the severity of the ischemic event. Using the 12 × 12 mm en face structural OCT images, we are able to demonstrate a wider area of ischemia in PAMM compared with the traditional 6 × 6 mm scans.

Original languageEnglish (US)
Article number101047
JournalAmerican Journal of Ophthalmology Case Reports
Volume22
DOIs
StatePublished - Jun 2021

Keywords

  • Ischemic cascade
  • Paracentral acute middle maculopathy (PAMM)
  • Peri-venular fern-like PAMM
  • Retinal artery occlusion
  • en face structure OCT

ASJC Scopus subject areas

  • Ophthalmology

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