2020–2021 BCSC Basic and Clinical Science Course™
12 Retina and Vitreous
Part II: Disorders of the Retina and Vitreous
Chapter 06: Retinal Vascular Diseases Associated With Cardiovascular Disease
Arterial Occlusive Disease
Paracentral Acute Middle Maculopathy
Paracentral acute middle maculopathy (PAMM) refers to acute ischemic events that affect the deep macular capillary layers. It is best visualized as hyperreflective bands on SD-OCT. There are 2 variants: type 1 affects the superficial capillary plexus in the outer plexiform layer (OPL)/inner nuclear layer (INL) region, and type 2 affects the deep capillary plexus in the OPL/outer nuclear layer (ONL) region. Visual consequences vary; upon resolution, type 1 lesions produce INL thinning, and type 2 lesions cause disturbance of the ellipsoid or inner segment and outer segment line.
Sarraf D, Rahimy E, Fawzi AA, et al. Paracentral acute middle maculopathy: a new variant of acute macular neuroretinopathy associated with retinal capillary ischemia. JAMA Ophthalmol. 2013;131(10):1275–1287.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.