PARACENTRAL ACUTE MIDDLE MACULOPATHY IN BEHCET DISEASE

Acute macular neuroretinopathy occurrence in a Behçet disease patient: a case report

PURPOSE

To report the occurrence of AMN (Acute Macular Neuroretinopathy) in a Behçet Disease (BD) patient during an active systemic inflammatory relapse and to describe the SD-OCT features of this entity.

PATIENTS AND METHODS

Retrospective observational case report of a patient who presented with an AMN during a BD associated ocular inflammation (Saint Pierre Hospital, Brussels, Belgium). Clinical record and imaging, including infrared reflectance image (IR) and spectral domain optical coherence tomography (SD-OCT), were analyzed.

RESULTS

A 25-year-old man presented with an acute right eye scotoma due to AMN in the setting of active systemic BD. Oral corticosteroid therapy and corticosteroid sparing agents (azathioprine) were prescribed. Close observation revealed progressive lesion regression.

CONCLUSION

In conclusion, the association between AMN and BD may occur in the context of active systemic disease, though further studies are required to better establish this link. Vigilance appears warranted during inflammatory episodes in BD, as they might contribute to such manifestations. Clinicians could consider BD as a potential differential diagnosis in patients presenting with features suggestive of AMN, and neurological involvement may merit cerebral imaging to exclude other causes. Additionally, the management of posterior uveitis in BD, if present, may benefit from timely and targeted treatment. Further investigations are necessary to refine management strategies for AMN in patients with BD.

Sequential Bilateral Paracentral Acute Middle Maculopathy in a Middle-Aged Woman

Purpose: To present a case of sequential paracentral acute middle maculopathy (PAMM) in a middle-aged woman with no cardiovascular risk factors. Methods: A single case was evaluated. Results: A 53-year-old woman with a history of PAMM resulting from perfused central retinal artery occlusion in the left eye presented with PAMM in the right eye 3 years later. The patient had a medical history of treated anemia, stress disorder, and insomnia. Examination of the right eye showed a superior parafoveal crescent of translucent retina without associated edema or hemorrhage. Optical coherence tomography (OCT) showed hyperreflective band-like areas in the superior parafoveal and perifoveal regions. Fluorescein angiography revealed normal arterial filling. OCT angiography showed patchy filling of the middle capillary plexus with normal perfusion of the superficial capillary plexus in the right eye. Conclusions: Although bilateral sequential PAMM is rare, close monitoring in a case of PAMM in 1 eye should be considered.