The authors present the first case of paracentral acute middle maculopathy as a manifestation of primary antiphospholipid syndrome (APS) with multimodal imaging, including optical coherence tomography angiography (OCTA). The association between APS and ophthalmic sequela is well-known. Recent advances in multimodal imaging, specifically OCTA, allow for better characterization of the mechanism and extent by which retinal arterial thrombosis can cause vision loss. Using advanced imaging modalities, the authors provide a comprehensive assessment of retinal ischemia, which showed not only localized capillary occlusion, but also ischemia of the deep retinal capillary plexus. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:175-178.].
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