Prevalence of resolved paracentral acute middle maculopathy lesions in fellow eyes of patients with unilateral retinal vein occlusion

Acta Ophthalmol. 2020 Feb;98(1):e22-e28. doi: 10.1111/aos.14196. Epub 2019 Jul 25.

Abstract

Purpose: To study the prevalence of resolved paracentral acute middle maculopathy (PAMM) lesions in fellow eyes of patients with unilateral retinal vein occlusion (RVO) and eyes of healthy individuals.

Methods: This case-control observational study took place in a referral university medical centre. Forty-five (17 males, 28 females, 64.7 ± 10.8 years) patients with branch retinal vein occlusion (BRVO), 21 (17 males, 4 females, 68.8 ± 11.2 years) patients with central retinal vein occlusion (CRVO) and 57 healthy individuals (25 males, 32 females, 67.4 ± 10.5 years) were included. Presence of resolved PAMM lesions was evaluated by reviewing cross-sectional scans of 8-mm optical coherence tomography angiography protocol. Resolved PAMM lesion was defined as inner nuclear layer thinning with outer plexiform layer elevation.

Results: Resolved PAMM lesions were found in 32/45 (71.1%) and 15/21 (71.4%) of BRVO and CRVO patients, respectively. In healthy volunteers, resolved PAMM lesions were found in 11/57 (19.3%) individuals with bilateral involvement in 8 individuals (72.7%). RVO patients demonstrated the presence of resolved PAMM lesions in fellow eye significantly more frequently than healthy individuals (odds ratio (OR) 10.6, p < 0.001, 95% CI 4.5-24.6). OR for the presence of large resolved PAMM lesions in BRVO patients and CRVO patients versus healthy individual was 12.1 (p = 0.02, 95% CI 1.5-100.9) and 22.4 (p = 0.005, 95% CI 2.5-200.6), respectively.

Conclusion: Resolved PAMM lesions defined as inner nuclear layer thinning associated with outer plexiform layer elevation are highly prevalent in fellow eyes of patients with unilateral RVO. Resolved PAMM lesions may have an association with RVO.

Keywords: branch retinal vein occlusion; central retinal vein occlusion; deep capillary plexus; foveal avascular zone; optical coherence tomography angiography; paracentral acute middle maculopathy; retinal ischaemia.