Paracentral acute middle maculopathy associated with non-arteritic ischemic optic neuropathy: a case report

Objective: To describe a case of paracentral acute middle maculopathy (PAMM) associated with non-arteritic anterior ischemic optic neuropathy (NAION). Methods: A 63-year-old patient presented with floaters (myodesopsia) and flashes of light (photopsia) associated with decreased visual acuity. Results: The visual field test revealed a centrocecal defect, and optical coherence tomography (OCT) showed hyperreflective areas in the inner nuclear layer in the temporal parafoveal region, along with alterations related to edema in the neuroretinal ring (RDNFL) secondary to NAION. Hypoperfusion and reduced vascular density were noted in the parafoveal and choroidal regions, as well as in the optic nerve (ON). Conclusion: Although there are no definitive treatments for these two pathologies, it is important to know how to interpret optical coherence tomography (OCT) and OCT angiography (OCTA). These non-invasive and reproducible techniques help monitor structural changes in these pathologies without the adverse effects of invasive tests.