{"id":9673,"date":"2021-04-23T10:20:57","date_gmt":"2021-04-23T08:20:57","guid":{"rendered":"https:\/\/albertobellone.it\/?p=9673"},"modified":"2021-05-10T23:49:08","modified_gmt":"2021-05-10T21:49:08","slug":"paracentral-acute-middle-maculopathy","status":"publish","type":"post","link":"https:\/\/albertobellone.it\/en\/paracentral-acute-middle-maculopathy\/","title":{"rendered":"Paracentral acute middle maculopathy as a finding in patients with severe vision loss following phacoemulsification cataract surgery"},"content":{"rendered":"<p>Paracentral acute middle maculopathy as a finding in patients with severe vision loss following phacoemulsification cataract surgery: PAMM following cataract surgery<\/p>\n<p>Source:<a href=\"https:\/\/www.researchgate.net\/publication\/315059728_Paracentral_acute_middle_maculopathy_as_a_finding_in_patients_with_severe_vision_loss_following_phacoemulsification_cataract_surgery_PAMM_following_cataract_surgery\"> https:\/\/www.researchgate.net\/publication\/315059728_Paracentral_acute_middle_maculopathy_as_a_finding_in_patients_with_severe_vision_loss_following_phacoemulsification_cataract_surgery_PAMM_following_cataract_surgery<\/a><\/p>\n<p><strong><span style=\"font-size: 20px;\">Authors:<\/span><\/strong><\/p>\n<p>Katarina Creese<br \/>\nDaini Ong<br \/>\nSukhpal Singh Sandhu<br \/>\nDavid Ware<br \/>\nC Alex Harper<br \/>\nSalmaan H Al-Qureshi<br \/>\nSanjeewa S Wickremasinghe<\/p>\n<p><strong><span style=\"font-size: 20px;\">Abstract<\/span><\/strong><\/p>\n<p><strong>Importance<\/strong>: Paracentral acute middle maculopathy (PAMM) diagnosed by spectral domain optical coherence tomography (SD-OCT) in patients with poor visual outcome post cataract surgery.<\/p>\n<p><strong>Background<\/strong>: Case series of severe vision loss due to PAMM after cataract surgery.<\/p>\n<p><strong>Design<\/strong>: Retrospective case series.<\/p>\n<p><strong>Participants<\/strong>: Cases from five surgical centres in Victoria, Australia.<\/p>\n<p><strong>Methods<\/strong>: Retrospective analysis of cases with unexplained &#8216;patch-off&#8217; vision loss post cataract surgery. All patients in our cohort had PAMM and presumed diagnosis of central or transient retinal artery occlusion.<\/p>\n<p><strong>Main outcome measures<\/strong>: A review of the patient histories focusing on pre-operative ocular and systemic vascular risk factors, anaesthetic and operative factors.<\/p>\n<p><strong>Results<\/strong>: Ten cases were included. All patients had 6\/72 Snellen visual acuity or worse noted on day one post surgery. Three patients had features of central retinal artery occlusion consisting of retinal pallor with a &#8216;cherry red&#8217; macula but absent relative afferent pupillary defect. Seven had no features of retinal pallor or attenuation of retinal arterioles. On SD-OCT, all eyes had evident PAMM. Six patients had a history of cardiovascular disease or blood dyscrasia.<\/p>\n<p><strong>Conclusions and relevance<\/strong>: PAMM should be considered in patients with &#8216;patch off&#8217; visual loss and absence of other fundal signs. We hypothesise that spasm or transient occlusion of central retinal artery leads to arterial hypoperfusion with subsequent ischaemia or infarction of the retina. Underlying arterial disease may have led to pre-existing hypoperfusion that may have been further compromised by raised intraocular pressure during the procedure itself or via raised orbital pressure from the anaesthesia.<\/p>\n<p><strong><span style=\"font-size: 20px;\">References:<\/span><\/strong><\/p>\n<p>Transient retinal artery occlusion during phacoemulsification cataract surgery<br \/>\nAug 2014<br \/>\nImran H Yusuf<br \/>\nT. H. M. Fung<br \/>\nMartin Wasik<br \/>\nChetan Kantibhai Patel<\/p>\n<p>Effects of peribulbar anesthesia on ocular blood flow in patients undergoing cataract surgery<br \/>\nJun 1999 AM J OPHTHALMOL<br \/>\nOliver Findl<br \/>\nSusanne Dallinger<br \/>\nRupert Menapace<br \/>\nLeopold Schmetterer<\/p>\n<p>Subcutaneous Single Injection Digital Block with Epinephrine<br \/>\nJan 2012<br \/>\nMotoki Sonohata<br \/>\nSatomi Nagamine<br \/>\nKazumasa Maeda<br \/>\nMasaaki Mawatari<\/p>\n<p>Adrenaline with lidocaine for digital nerve blocks<br \/>\nJul 2013 COCHRANE DB SYST REV<br \/>\nHemanshu Prabhakar<br \/>\nSantosh Rath<br \/>\nMani Kalaivani<\/p>\n<p>Safety of Epinephrine in Digital Nerve Blocks: A Literature Review<br \/>\nAug 2015 J EMERG MED<br \/>\nJonathan Ilicki<\/p>\n<p>Spectrum of Retinal Vascular Diseases Associated With Paracentral Acute Middle Maculopathy<br \/>\nApr 2015<br \/>\nXuejing Chen<br \/>\nEhsan Rahimy<br \/>\nRobert C. 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Leoni<br \/>\nJean-Fran\u00e7ois Korobelnik<\/p>\n<p>Intraocular Pressure and Calculated Diastolic Ocular Perfusion Pressure during Three Simulated Steps of Phacoemulsification In Vivo<br \/>\nMay 2009 Investig Ophthalmol Vis Sci<br \/>\nYune Zhao<br \/>\nXingyu Li<br \/>\nAizhu Tao<br \/>\nFan Lu<\/p>\n<p>Retinal Toxicity Secondary to intraocular Gentamicin Injection<br \/>\nAug 1986 OPHTHALMOLOGY<br \/>\nH. Richard McDonald<br \/>\nHoward Schatz<br \/>\nArthur W. Allen<br \/>\nJ. Dennis Snider<\/p>\n<p>Prostaglandins and Cystoid Macular Edema<br \/>\nSep 2002 SURV OPHTHALMOL<br \/>\nKensaku Miyake<br \/>\nNobuhiro Ibaraki<\/p>\n<p>Transient central retinal artery occlusion after posterior sub-Tenon&#8217;s anesthesia<br \/>\nOct 2003 J CATARACT REFR SURG<br \/>\nRobert Feibel<br \/>\nDavid L Guyton<\/p>\n<p>Central retinal artery occlusion after peribulbar anesthesia<br \/>\nMay 2004 J CATARACT REFR SURG<br \/>\nAlbert Vinerovsky<br \/>\nEitan Z Rath<br \/>\nUri Rehany<br \/>\nShimon Rumelt<\/p>\n<p>ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Preliminary report of principal results from a European multicenter study<br \/>\nMar 2006 J CATARACT REFR SURG<br \/>\nPeter Barry<br \/>\nDavid Seal<br \/>\nG Gettinby<br \/>\nCrawford W Revie<\/p>\n<p>Effects of the Local Anaesthetic Ropivacaine on Vascular Reactivity in the Mouse Perfused Mesenteric Arteries<br \/>\nJun 2006 BASIC CLIN PHARMACOL<br \/>\nClarisse F Timponi<br \/>\nNilton E Oliveira<br \/>\nRoberia M P Arruda<br \/>\nElisardo C Vasquez<\/p>\n<p>Crystalline Retinopathies<br \/>\nNov 2006 SURV OPHTHALMOL<br \/>\nKimberly A Drenser<br \/>\nDavid Sarraf<br \/>\nAtul Jain<br \/>\nKent W Small<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Paracentral acute middle maculopathy as a finding in patients with severe vision loss following phacoemulsification cataract surgery: PAMM following cataract surgery Source: https:\/\/www.researchgate.net\/publication\/315059728_Paracentral_acute_middle_maculopathy_as_a_finding_in_patients_with_severe_vision_loss_following_phacoemulsification_cataract_surgery_PAMM_following_cataract_surgery Authors: Katarina Creese Daini Ong Sukhpal Singh Sandhu David Ware C Alex Harper Salmaan H Al-Qureshi Sanjeewa S Wickremasinghe Abstract Importance: Paracentral acute middle maculopathy (PAMM) diagnosed by spectral domain optical coherence [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":9676,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3702],"tags":[],"class_list":["post-9673","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research"],"_links":{"self":[{"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/posts\/9673","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/comments?post=9673"}],"version-history":[{"count":0,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/posts\/9673\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/media\/9676"}],"wp:attachment":[{"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/media?parent=9673"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/categories?post=9673"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/albertobellone.it\/en\/wp-json\/wp\/v2\/tags?post=9673"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}