Paracentral Acute Middle Maculopathy as a Specific Sign of Arteritic Anterior Ischemic Optic Neuropathy - 21/03/23
, Pierre Gascon a, Natacha Stolowy a, b, Alban Comet a, Ruben Attia a, Marie Beylerian a, b, Brigitte Granel a, b, Pierre-André Jarrot a, b, David Jacob Cohen a, Gabriel Guez c, Natanael Levy a, b, Danièle Denis a, c, b, Thierry David a, bHighlights |
• | Paracentral acute middle maculopathy associated with anterior ischemic optic neuropathy is a specific sign of giant cell arteritis. |
• | Paracentral acute middle maculopathy is frequently associated with arteritic anterior ischemic optic neuropathy. |
• | Macular optical coherence tomography should be performed in any suspicion of giant cell arteritis looking for paracentral acute middle maculopathy. |
Résumé |
Purpose |
The purpose of this study is to assess the diagnostic accuracy of paracentral acute middle maculopathy (PAMM) in the setting of anterior ischemic optic neuropathy (AION) to distinguish arteritic (A-AION) from nonarteritic (NA-AION) type.
Design |
Retrospective cross-sectional diagnostic evaluation.
Methods |
PAMM was evaluated by 3 physicians blinded to diagnosis using macular spectral-domain optical coherence tomography. We studied 45 patients with AION. Of those, 28 had NA-AION and 17 had A-AION. The study was conducted in the Department of Ophthalmology at the Hospital of Marseille—Assistance Publique, France, from January 1, 2018, to March 31, 2022.
Results |
PAMM were only found in the A-AION group (N = 4) (P = .0143). As a distinctive sign of A-AION, we found a specificity of 100% (95% IC, 88.06%-100%) and a positive predictive value of 100%. In contrast, sensitivity and negative predictive value were lower, 19.1% (95% IC, 5.5-42.0) and 63.0% (95% CI, 58.1-67.7), respectively.
Conclusions |
The PAMM finding is highly specific for A-AION in the setting of AION. According to our results, macular spectral-domain optical coherence tomography looking for PAMM should be performed with any patient presenting with AION.
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Vol 248
P. 1-7 - avril 2023 Retour au numéro
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