PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH BRANCH RETINAL ARTERY OCCLUSION DUE TO POLYCYTHEMIA IN A PATIENT WITH TETRALOGY OF FALLOT.

ABSTRACT

PURPOSE: To describe the occurrence of paracentral acute middle maculopathy (PAMM) associated with branch retinal artery occlusion secondary to polycythemia in a patient with tetralogy of Fallot. METHODS: Case report. RESULTS: A 30-year-old man presented with acute vision loss and superior visual deficit in his left eye for two days. His medical record had a tetralogy of Fallot. Complete blood count showed an erythrocyte count of 9.88 million/µL (4.4-5.6), hemoglobin of 17.7 g/dL (13.5-16.9), and hematocrit of 65.4% (40-49). The best-corrected visual acuity was 20/25 in the left eye, and a diagnosis of left inferotemporal branch retinal artery occlusion was made. Spectral-domain optical coherence tomography revealed a characteristic hyperreflective band-like lesion on the inner nuclear layer consistent with PAMM. CONLUSION Polycythemia may be a trigger for branch retinal artery occlusion-associated PAMM. We suggest a new precursor cause of PAMM that is previously undescribed.