@article{3194272,
    title = "Paracentral Acute Middle Maculopathy following Surgically Induced Branch
Retinal Artery Occlusion During Vitrectomy",
    author = "Stavrakas, Panagiotis and Karmiris, Efthymios and Tranos, Paris and and Ananikas, Konstantinos and Tooulias, Christos and Rouvas, Alexandros and and Androu, Angeliki",
    journal = "Case Reports in Ophthalmology",
    year = "2021",
    volume = "12",
    number = "1",
    pages = "25-31",
    publisher = "Karger",
    issn = "1663-2699",
    doi = "10.1159/000510558",
    keywords = "Paracentral acute middle maculopathy; Capillary ischaemia; Pars plana
vitrectomy",
    abstract = "Paracentral acute middle maculopathy (PAMM) is a spectral-domain OCT
finding of a thickened hyperreflective band at the level of the
intermediate layers of the inner retina, attributed to the acute phase
of intermediate capillary ischemia. The purpose of this paper is to
report a case of PAMM deriving from a surgically induced branch retinal
artery occlusion (BRAO) during vitrectomy for vitreous hemorrhage. A
70-year-old female referred to the posterior segment office with a
1-month history of visual loss in her right eye. Best-corrected visual
acuity (BCVA) was “counting-fingers” (CF) due to a dense vitreous
hemorrhage. She underwent a standard 23-gauge vitrectomy with a
relatively close to the optic disc endodiathermy application to an
avulsed vessel. Follow-up examination revealed a well-demarcated retinal
whitening involving the inferior macula. SD OCT showed a surgically
induced branch retinal artery occlusion exhibiting both a cotton wool
spot and a PAMM lesion. Our case affords an insight into those
pathological processes involved with PAMM, providing angiographic
evidence of the retinal ischemic changes responsible for its
development, by angiographically proving that branch retinal artery
occlusion leads to a prompt formation of both a cotton wool spot and a
PAMM lesion. Our aim is to raise awareness of this potential
complication of vitrectomy surgery, especially when involving multiple
traumatic manipulations onto the retinal surface."
}