title: Optical coherence tomographic angiography shows reduced deep capillary flow in paracentral acute middle maculopathy.
abstract: BACKGROUND
  Paracentral acute middle maculopathy (PAMM) has been described as an ischemic lesion of the middle retinal layers with a characteristic lamellar hyper-reflective placoid appearance in the acute phase and thinning of the involved retinal layers in the chronic phase. Optical coherence tomographic angiography (OCTA) is a novel and non-invasive technique for imaging retinal capillary vasculature with en face segmentation capabilities.
  
  
  METHODS
  Case series. We describe two patients with PAMM who underwent clinical examination and multimodal imaging including OCTA.
  
  
  RESULTS
  In the first patient, who presented with PAMM secondary to acute cilioretinal artery occlusion, OCTA demonstrated reduction in flow in the deep capillary plexus (DCP). One month later, OCTA revealed a flow void due to thinning of the GCL, INL, and OPL and paradoxical apparent ONL thickening. Similar findings of focal retinal lamellar ectopia were seen in the second patient, who had an incidentally detected chronic PAMM lesion.
  
  
  CONCLUSIONS
  OCTA images the superficial and deep capillary plexi independently. PAMM is characterized by acute and chronic attenuation of the DCP flow signature. Focal lamellar ectopia in PAMM is discussed.
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York, USA.|LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA.|Moorfields Eye Hospital, London, UK.
authors.forename: K K
authors.initials: KK
authors.lastname: Dansingani
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York, USA.|LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA.
authors.forename: M
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York, USA.|LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA.|Department of Ophthalmology, New York University School of Medicine, New York, New York, USA.
authors.forename: M
authors.initials: M
authors.lastname: Engelbert
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York, USA.|LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA.|Department of Ophthalmology, New York University School of Medicine, New York, New York, USA.|Department of Ophthalmology, North-Shore Long Island Jewish Health System, Manhasset, New York, USA.
authors.forename: K B
authors.initials: KB
authors.lastname: Freund
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D002196:Capillaries / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015356:Retinal Artery Occlusion / Q000503:physiopathology; D012164:Retinal Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D055351:Retinal Neurons; D012171:Retinal Vessels / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods