Paracentral acute middle maculopathy in systemic sclerosis and subsequent branch retinal artery occlusion

Miki Takao; Akio Oishi; Toshimasa Shimizu; Yutaka Kuwatsuka; Takashi Kitaoka

doi:10.1016/j.ajoc.2023.101955

Paracentral acute middle maculopathy in systemic sclerosis and subsequent branch retinal artery occlusion

Am J Ophthalmol Case Rep. 2023 Nov 4:32:101955. doi: 10.1016/j.ajoc.2023.101955. eCollection 2023 Dec.

Authors

Miki Takao^{1

2}, Akio Oishi¹, Toshimasa Shimizu³, Yutaka Kuwatsuka⁴, Takashi Kitaoka¹

Affiliations

¹ Department of Ophthalmology and Visual Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
² Department of Ophthalmology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
³ Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
⁴ Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Abstract

Purpose: We report a case of systemic sclerosis-associated paracentral acute middle maculopathy (PAMM) in a young woman who subsequently developed branch retinal artery occlusion.

Observations: A 22-year-old woman presented with a paracentral scotoma. Optical coherence tomography (OCT) revealed bilateral paracentral acute middle maculopathy. Upon systemic examination, she was diagnosed with systemic sclerosis (SSc). She subsequently developed branch retinal artery occlusion despite vasodilator medications. After the prescription of aspirin, she did not experience a new event for one year.

Conclusion and importance: This case illustrates that SSc may affect the retinal vascular system and vision and cause PAMM. The optimal prophylaxis for patients with recurrent retinal events should be investigated in future studies.

Keywords: Branch retinal artery occlusion; Migraines; PAMM; Paracentral scotoma; Raynaud's phenomenon; Scleroderma; Systemic sclerosis.

Publication types

Case Reports