Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membrane
Purpose: To describe two cases of extramacular paracentral acute middle maculopathy (PAMM)-like retinal ischemia after vitrectomy with internal limiting membrane (ILM) peeling for epiretinal membrane (ERM). Observations: Case 1 involved a 78-year-old woman with a history of hyperlipidemia and preope...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
|
| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624002317 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846117839137669120 |
|---|---|
| author | Chihiro Koiwa Pingyu Chi Shutaro Yamamoto Shintaro Nakao |
| author_facet | Chihiro Koiwa Pingyu Chi Shutaro Yamamoto Shintaro Nakao |
| author_sort | Chihiro Koiwa |
| collection | DOAJ |
| description | Purpose: To describe two cases of extramacular paracentral acute middle maculopathy (PAMM)-like retinal ischemia after vitrectomy with internal limiting membrane (ILM) peeling for epiretinal membrane (ERM). Observations: Case 1 involved a 78-year-old woman with a history of hyperlipidemia and preoperative visual acuity (VA) of 20/20. Case 2 involved a 72-year-old man with a history of hypertension and hyperlipidemia, and preoperative VA of 20/32. In both cases, cataract surgery and vitrectomy with ILM peeling were performed for the unilateral ERM and cataract. On postoperative day 1, retinal whitening was observed at separate extramacular areas from ILM peeling in the macular region in both cases. Optical coherence tomography revealed a high-intensity reflection in the inner nuclear layer, and optical coherence tomography angiography showed a perfusion defect in the deep capillary plexus (DCP), which corresponded to the area of retinal whitening. Fluorescein angiography revealed no significant abnormalities, leading to a diagnosis of PAMM-like retinal ischemia. In Case 1, retinal whitening disappeared at postoperative week 2, and the corrected VA improved to 20/20 at postoperative month (POM) 6. In Case 2, retinal whitening resolved at POM 1 and POM 4.5, and VA improved to 20/16. However, both cases showed residual perfusion defects in some deep retinal vessels, accompanied by scotomas corresponding to these areas. Conclusions and importance: We observed two cases of extramacular PAMM-like retinal ischemia that developed after vitrectomy with ILM peeling. Although both cases showed improved VA, blood flow disturbances at the DCP level and associated visual field defects persisted. |
| format | Article |
| id | doaj-art-ccd3337cf12b4da3b14f5d81942d6e12 |
| institution | Kabale University |
| issn | 2451-9936 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-ccd3337cf12b4da3b14f5d81942d6e122024-12-18T08:50:51ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-0136102221Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membraneChihiro Koiwa0Pingyu Chi1Shutaro Yamamoto2Shintaro Nakao3Corresponding author. Department of Ophthalmology, Juntendo University School of Medicine, 2-1-1Hongo, Bunkyo-Ku, Tokyo, 113-8431, Japan.; Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Ophthalmology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Ophthalmology, Juntendo University School of Medicine, Tokyo, JapanDepartment of Ophthalmology, Juntendo University School of Medicine, Tokyo, JapanPurpose: To describe two cases of extramacular paracentral acute middle maculopathy (PAMM)-like retinal ischemia after vitrectomy with internal limiting membrane (ILM) peeling for epiretinal membrane (ERM). Observations: Case 1 involved a 78-year-old woman with a history of hyperlipidemia and preoperative visual acuity (VA) of 20/20. Case 2 involved a 72-year-old man with a history of hypertension and hyperlipidemia, and preoperative VA of 20/32. In both cases, cataract surgery and vitrectomy with ILM peeling were performed for the unilateral ERM and cataract. On postoperative day 1, retinal whitening was observed at separate extramacular areas from ILM peeling in the macular region in both cases. Optical coherence tomography revealed a high-intensity reflection in the inner nuclear layer, and optical coherence tomography angiography showed a perfusion defect in the deep capillary plexus (DCP), which corresponded to the area of retinal whitening. Fluorescein angiography revealed no significant abnormalities, leading to a diagnosis of PAMM-like retinal ischemia. In Case 1, retinal whitening disappeared at postoperative week 2, and the corrected VA improved to 20/20 at postoperative month (POM) 6. In Case 2, retinal whitening resolved at POM 1 and POM 4.5, and VA improved to 20/16. However, both cases showed residual perfusion defects in some deep retinal vessels, accompanied by scotomas corresponding to these areas. Conclusions and importance: We observed two cases of extramacular PAMM-like retinal ischemia that developed after vitrectomy with ILM peeling. Although both cases showed improved VA, blood flow disturbances at the DCP level and associated visual field defects persisted.http://www.sciencedirect.com/science/article/pii/S2451993624002317ArteriosclerosisLocal anesthesiaParacentral scotoma |
| spellingShingle | Chihiro Koiwa Pingyu Chi Shutaro Yamamoto Shintaro Nakao Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membrane American Journal of Ophthalmology Case Reports Arteriosclerosis Local anesthesia Paracentral scotoma |
| title | Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membrane |
| title_full | Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membrane |
| title_fullStr | Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membrane |
| title_full_unstemmed | Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membrane |
| title_short | Extramacular paracentral acute middle maculopathy-like retinal ischemia after vitrectomy for epiretinal membrane |
| title_sort | extramacular paracentral acute middle maculopathy like retinal ischemia after vitrectomy for epiretinal membrane |
| topic | Arteriosclerosis Local anesthesia Paracentral scotoma |
| url | http://www.sciencedirect.com/science/article/pii/S2451993624002317 |
| work_keys_str_mv | AT chihirokoiwa extramacularparacentralacutemiddlemaculopathylikeretinalischemiaaftervitrectomyforepiretinalmembrane AT pingyuchi extramacularparacentralacutemiddlemaculopathylikeretinalischemiaaftervitrectomyforepiretinalmembrane AT shutaroyamamoto extramacularparacentralacutemiddlemaculopathylikeretinalischemiaaftervitrectomyforepiretinalmembrane AT shintaronakao extramacularparacentralacutemiddlemaculopathylikeretinalischemiaaftervitrectomyforepiretinalmembrane |