title: Assessing Deep Retinal Capillary Ischemia in Paracentral Acute Middle Maculopathy by Optical Coherence Tomography Angiography.
abstract: OBJECTIVE
  To assess microvascular blood flow of the deep retinal capillary plexus in eyes with paracentral acute middle maculopathy using optical coherence tomography (OCT) angiography.
  
  
  METHODS
  Retrospective, multicenter observational case series.
  
  
  METHODS
  Clinical and multimodal imaging findings from 8 patients with paracentral acute middle maculopathy were reviewed and analyzed. OCT angiography scans were analyzed and processed, and vessel density was calculated.
  
  
  RESULTS
  Eight patients (7 male, 1 female, aged 9-82 years) were included. OCT angiography was obtained at either the acute (4 cases) or old stage (4 cases). Scans of the deep capillary plexus showed preservation of perfusion in acute lesions and capillary attenuation in old cases. Cases of central retinal artery occlusion showed marked loss of the deep capillary plexus. The mean vessel density of the superficial capillary plexus in normal fellow eyes was 12.8 ± 1.8 mm(-1) vs 12.1 ± 1.9 mm(-1) in eyes with paracentral acute middle maculopathy (reduction -6.0%, P = .08). The mean vessel density of the deep capillary plexus in normal fellow eyes was 17.5 ± 1.4 mm(-1) vs 14.7 ± 3.5 mm(-1) in eyes with paracentral acute middle maculopathy (reduction -19.4%, P = .04). This significant difference was representative of the eyes with old lesions.
  
  
  CONCLUSIONS
  Paracentral acute middle maculopathy lesions correspond to preservation of perfusion in focal acute lesions and to pruning of the plexus in old cases. Cases of central retinal artery occlusion demonstrate marked hypoperfusion of the deep capillary plexus. Our study further supports an ischemic pathogenesis of this retinal vasculopathy.
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
authors.forename: Julia
authors.initials: J
authors.lastname: Nemiroff
authors.affiliation: Institute for Ophthalmic Research, Center for Ophthalmology, Eberhard Karls University Tübingen, Tübingen, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Kuehlewein
authors.affiliation: Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Rahimy
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
authors.forename: Irena
authors.initials: I
authors.lastname: Tsui
authors.affiliation: Kaiser Permanante, Tustin, California.
authors.forename: Rishi
authors.initials: R
authors.lastname: Doshi
authors.affiliation: Ophtalmologie, Hopital Lariboisiere, AP-HP, Université Paris 7 - Sorbonne Paris Cité, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Gaudric
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Gorin
authors.affiliation: Institute for Ophthalmic Research, Center for Ophthalmology, Eberhard Karls University Tübingen, Tübingen, Germany.
authors.forename: SriniVas
authors.initials: S
authors.lastname: Sadda
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California; Greater Los Angeles Veterans Affairs Healthcare Center, Los Angeles, California. Electronic address: dsarraf@ucla.edu.
authors.forename: David
authors.initials: D
authors.lastname: Sarraf
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002196:Capillaries / Q000473:pathology; D002648:Child; D002908:Chronic Disease; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007511:Ischemia / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000175:diagnosis*; D055351:Retinal Neurons / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology*; D012189:Retrospective Studies; D012607:Scotoma / Q000175:diagnosis*; D041623:Tomography, Optical Coherence