Paracentral acute middle maculopathy in a patient with frequent migraine with aura: a case report
Abstract
This case report describes a patient with migraine with visual aura who presented with a monocular, painless paracentral scotoma. Her optical coherence tomography and exam findings were consistent with paracentral acute middle maculopathy. Migraine with aura can cause structural changes to the retinal microvasculature. We propose the possibility of a link between migraine and paracentral acute middle maculopathy. Background/Purpose: To explore the possible relationship between Paracentral Acute Middle Maculopathy (PAMM) and migraine. Paracentral acute middle maculopathy is a recently described clinical and optical coherence tomography entity involving infarction of the inner nuclear layer secondary to deep retinal capillary ischemia. It presents as a painless paracentral scotoma and often results in permanent visual deficits. Migraine, especially migraine with aura, has been shown to cause structural changes in the retinal microvasculature and to be a risk factor for retinal ischemia. Methods: A case report and review of the literature. Results: A 39-year-old woman with migraine with visual aura presented with a discrete, monocular, painless “buffalo-shaped” paracentral scotoma, which started during a period of frequent typical visual auras. Her exam and optical coherence tomography were consistent with PAMM. Conclusion: We propose that migraine is a risk factor for the development of PAMM. The changes in retinal microvasculature in migraine may increase a patient's…
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