Exploring Patient Demographics and Presence of Retinal Vascular Disease in Paracentral Acute Middle Maculopathy

center dot PURPOSE: To investigate the sociodemographic profile, the association with retinal vascular diseases (RVD) and systemic comorbidities, and visual outcomes of patients with paracentral acute middle maculopathy (PAMM) in a large, ethnically diverse single-center cohort. center dot DESIGN: Retrospective cohort study. center dot METHODS: Electronic health record query for all patients presenting with PAMM at Moorfields Eye Hospital, London, was completed. Detailed demographic, clinical, and systemic information were collected and analyzed. center dot RESULTS: A total of 78 eyes of 78 patients with confirmed PAMM were included in the study. Forty patients (51.3%) presented with no RVD, 20 patients (25.6%) with retinal vein occlusion (RVO), 16 patients (20.5%) with retinal artery occlusion (RAO), and 2 patients (2.6%) with concomitant RAO and RVO. Patients with PAMM +RAO were older than those with RVO ( P = .02) and more likely to have a history of major adverse cardiovascular events (MACE) ( P = .01), with a significantly worse presenting best corrected visual acuity (BCVA) (20/50) compared to patients with RVO ( P = .02) and no RVD ( P < .001). Individuals with isolated PAMM had a significantly higher prevalence of previous MACE ( P = .04) and sickle cell disease (SCD) ( P = .04) compared to those with RVO. At the last follow-up, 64 patients (85.3%) had a good BCVA ( > 20/32). center dot CONCLUSIONS: The significant association of PAMM with RVD supports the hypothesis of an ischemic etiology. Individuals with isolated PAMM had a higher prevalence of MACE and SCD. Thus, it is important to prompt immediate referral for a comprehensive systemic evaluation. Across the whole cohort, PAMM was associated with good BCVA improvement during follow-up, indicating a good visual prognosis. (Am J Ophthalmol 2024;260: 182-189. (c) 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ ))