Paracentral Acute Middle Maculopathy as a Specific Sign of Arteritic Anterior Ischemic Optic Neuropathy.

Am J Ophthalmol

From the Centre Hospitalier Universitaire de l'Hôpital Nord, (K.M., P.G., N.S., A.C., R.A., M.B., B.G., P.-A.J., N.L., D.D., T.D.); Faculty of Medicine, Aix-Marseille University (N.S., M.B., B.G., P.-A.J., N.L., D.D., T.D.), Marseille, France.

Published: April 2023


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Article Abstract

Purpose: The purpose of this study is to assess the diagnostic accuracy of paracentral acute middle maculopathy (PAMM) in the setting of anterior ischemic optic neuropathy (AION) to distinguish arteritic (A-AION) from nonarteritic (NA-AION) type.

Design: Retrospective cross-sectional diagnostic evaluation.

Methods: PAMM was evaluated by 3 physicians blinded to diagnosis using macular spectral-domain optical coherence tomography. We studied 45 patients with AION. Of those, 28 had NA-AION and 17 had A-AION. The study was conducted in the Department of Ophthalmology at the Hospital of Marseille-Assistance Publique, France, from January 1, 2018, to March 31, 2022.

Results: PAMM were only found in the A-AION group (N = 4) (P = .0143). As a distinctive sign of A-AION, we found a specificity of 100% (95% IC, 88.06%-100%) and a positive predictive value of 100%. In contrast, sensitivity and negative predictive value were lower, 19.1% (95% IC, 5.5-42.0) and 63.0% (95% CI, 58.1-67.7), respectively.

Conclusions: The PAMM finding is highly specific for A-AION in the setting of AION. According to our results, macular spectral-domain optical coherence tomography looking for PAMM should be performed with any patient presenting with AION.

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http://dx.doi.org/10.1016/j.ajo.2022.09.019DOI Listing

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