Clinical Ophthalmology (Nov 2023)

Paracentral Acute Middle Maculopathy Following Acute Primary Angle Closure and Acute Primary Angle Closure Glaucoma

  • Xiao H,
  • Guo N,
  • Li J,
  • Jin L,
  • Liu Y,
  • Lin S,
  • Fang L,
  • Liu X,
  • Zuo C

Journal volume & issue
Vol. Volume 17
pp. 3513 – 3523

Abstract

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Hui Xiao,* Ni Guo,* Junyi Li, Ling Jin, Yuan Liu, Shufen Lin, Lei Fang, Xing Liu, Chengguo Zuo State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xing Liu; Chengguo Zuo, Zhongshan Ophthalmic Center, Sun Yat-sen University, 7 Jinsui Road, Guangzhou, 510000, People’s Republic of China, Email [email protected]; [email protected]: To report the prevalence, clinical characteristics and risk factors for paracentral acute middle maculopathy (PAMM) following acute primary angle closure (APAC) and acute primary angle closure glaucoma (APACG).Methods: This retrospective study consecutively recruited patients diagnosed with APAC or APACG. Based on the spectral domain optical coherence tomography characteristics, PAMM eyes were divided into three stages. Characteristics of different stages such as the time from symptoms to treatment (TST), retinal thickness and BCVA improvement were analyzed. The risk factors of PAMM were evaluated by binary logistic regression models.Results: A total of 781 eyes of 781 APAC or APACG patients were included, and PAMM was found in 22 (2.9%) of them. Stage III eyes had a significantly longer TST than stage I eyes (P = 0.008) while exhibiting significantly thinner retinal thicknesses (P < 0.0001). The BCVA improvement was significantly worse in the eyes treated in stage III than in those treated in stage I (P = 0.008). Older age, longer axial length and without type 2 diabetes were associated with a lower risk of incident PAMM (OR = 0.95, P = 0.028; OR = 0.52, P = 0.019; OR = 3.92, P = 0.022).Conclusion: PAMM can be secondary to APAC or APACG at a rate of 2.9%. Different visual outcomes were observed in patients who received the intervention at different stages of PAMM. Younger patients with a shorter axial length and type 2 diabetes were found to be more susceptible to PAMM.Keywords: paracentral acute middle maculopathy, acute primary angle closure, acute primary angle closure glaucoma, risk factors, spectral domain optical coherence tomography

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