Paracentral Acute Middle Maculopathy Following Acute Primary Angle Closure and Acute Primary Angle Closure Glaucoma

Abstract

Purpose

To report the prevalence, clinical characteristics and risk factors for paracentral acute middle maculopathy (PAMM) following acute primary angle closure (APAC) and acute primary angle closure glaucoma (APACG).

Methods

This retrospective study consecutively recruited patients diagnosed with APAC or APACG. Based on the spectral domain optical coherence tomography characteristics, PAMM eyes were divided into three stages. Characteristics of different stages such as the time from symptoms to treatment (TST), retinal thickness and BCVA improvement were analyzed. The risk factors of PAMM were evaluated by binary logistic regression models.

Results

A total of 781 eyes of 781 APAC or APACG patients were included, and PAMM was found in 22 (2.9%) of them. Stage III eyes had a significantly longer TST than stage I eyes (P = 0.008) while exhibiting significantly thinner retinal thicknesses (P < 0.0001). The BCVA improvement was significantly worse in the eyes treated in stage III than in those treated in stage I (P = 0.008). Older age, longer axial length and without type 2 diabetes were associated with a lower risk of incident PAMM (OR = 0.95, P = 0.028; OR = 0.52, P = 0.019; OR = 3.92, P = 0.022).

Conclusion

PAMM can be secondary to APAC or APACG at a rate of 2.9%. Different visual outcomes were observed in patients who received the intervention at different stages of PAMM. Younger patients with a shorter axial length and type 2 diabetes were found to be more susceptible to PAMM.

Keywords:

• paracentral acute middle maculopathy
• acute primary angle closure
• acute primary angle closure glaucoma
• risk factors
• spectral domain optical coherence tomography

Acknowledgments

We would like to acknowledge Dingqiao Wang, Huanyang Shi, Zhihong Huang and Shaoyang Zheng who are the research group members for their guidance and support in completing this project, and all the participants who made our study possible.

Ethics Approval

Approval for this study was obtained from the Institutional Review Board of the Zhongshan Ophthalmic Center, Sun Yat-sen University (Approval number: 2022KYPJ250) and the study followed the principles of the Declaration of Helsinki. Informed consent from patients in the study was waived because the data were collected retrospectively. We only analyzed patient case data without any intervention or additional examinations. All patient data were protected and kept confidential by the researchers.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China grants 81970808, and by Natural Science Foundation of Guangdong Province grants 2022A1515011469.