First Author: W.Ibrahim EGYPT
Co Author(s): Z. Eldaly
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To highlight a characteristic FAF finding in a patient suffering from PAMM and its impact on suspicion of PAMM in absence of OCT-Angiography in your facility.
A case report study was conducted in the Department of Ophthalmology Assiut University Hospital, Assiut, Egypt.
A 48 year old male presented to our clinic by sudden blurring of vision with persistent scotoma. Patient underwent detailed ophthalmic history taking, full ophthalmic evaluation and a thorough systemic work up. FFA, FAF, SS-OCT, OCT-Angiography and VF were done to reach the final diagnosis.
Our patient had unremarkable ocular and medical history. He had BCVA of 0.1 in both eyes, unremarkable anterior segment evaluation, RRR pupils, within normal IOP and fullocular motility. FFA was unremarkable, however SS-OCT revealed multiple high reflective bands in middle retinal layers with otherwise preserved retinal architecture. FAF revealed multifocal hypo-auto-fluorescent patches involving the macular region corresponding well to middle retinal layer high reflective bands. OCT-Angiography was done and characteristic multifocal areas of no-flow (ischaemia) in deep capillary plexus with intact superficial capillary plexus. VF was done and revealed multiple isolated paracentral scotoma. A diagnosis of PAMM was confirmed.
PAMM is a rare deep capillary plexus disorder that was highlighted by the advent of OCT-Angiography. However, OCT-Angiography is not available in every facility in our country. Correlating OCT and FAF findings in suspicious cases may provide a strong indication for referring our patient for OCT-Angiography with high positive yield.