PMID- 30126649
OWN - NLM
STAT- In-Data-Review
LR  - 20181120
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 125
IP  - 12
DP  - 2018 Dec
TI  - Paracentral Acute Middle Maculopathy following Vitrectomy for Proliferative
      Diabetic Retinopathy: Incidence, Risk Factors, and Clinical Characteristics.
PG  - 1929-1936
LID - S0161-6420(18)30905-9 [pii]
LID - 10.1016/j.ophtha.2018.07.006 [doi]
AB  - PURPOSE: To report the incidence of, risk factors for, and characteristics of
      paracentral acute middle maculopathy (PAMM) after 25-gauge pars plana vitrectomy 
      for proliferative diabetic retinopathy (PDR). DESIGN: Retrospective, consecutive,
      interventional case series. PARTICIPANTS: Five hundred thirty eyes of 427
      patients who underwent primary vitrectomy for PDR from 2013 through 2016.
      METHODS: The patients underwent measurement of best-corrected visual acuity
      (BCVA), fundus photography, and OCT before and within 2 weeks after vitrectomy. A
      generalized linear mixed-effects model was used to evaluate risk factors for
      development of PAMM. MAIN OUTCOME MEASURES: The incidence, associated risk
      factors, and clinical characteristics of PAMM following vitrectomy, including the
      change in BCVA in eyes with PAMM and the distribution of PAMM as determined by en
      face OCT. RESULTS: Four hundred ninety-six eyes of 395 patients who met the
      eligibility criteria were evaluated. The incidence of PAMM was 3.8% (15/395) for 
      patients and 3.6% (18/496) for eyes. Multivariate analysis showed the significant
      risk factors for PAMM development to be younger age (mean age, 49 years in
      patients and 59 years in control participants; odds ratio [OR] 0.94; 95%
      confidence interval [CI], 0.89-0.99; P = 0.021) and female gender (66.7% of
      patients and 31.3% of control participants; OR, 4.48; 95% CI, 1.57-12.6; P =
      0.005). The PAMM was distributed on either side of the causative arterioles. In
      14 of the 18 eyes (78%), PAMM was located within a 3-mm diameter of the fovea. In
      10 eyes (56%), PAMM measured 1 disc diameter or more, and in 5 eyes (28%), PAMM
      measured one third disc diameter or less. No emboli were found in any eyes;
      however, multiple segmental arterial constrictions were confirmed during
      vitrectomy in 1 eye. The BCVA decreased more than 2 lines in 2 eyes (5%).
      CONCLUSIONS: Paracentral acute middle maculopathy can develop after pars plana
      vitrectomy for PDR, especially in patients who are younger and female. Impaired
      blood flow in arterioles, which leads to tissue hypoxia, was associated with
      development of PAMM.
CI  - Copyright (c) 2018 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Nakashima, Hiroshi
AU  - Nakashima H
AD  - Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ
      Disability, Osaka, Japan. Electronic address: hirosshi78@gmail.com.
FAU - Iwama, Yasuaki
AU  - Iwama Y
AD  - Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ
      Disability, Osaka, Japan.
FAU - Tanioka, Kensuke
AU  - Tanioka K
AD  - Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama,
      Japan.
FAU - Emi, Kazuyuki
AU  - Emi K
AD  - Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ
      Disability, Osaka, Japan.
LA  - eng
PT  - Journal Article
DEP - 20180817
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
EDAT- 2018/08/22 06:00
MHDA- 2018/08/22 06:00
CRDT- 2018/08/22 06:00
PHST- 2018/04/03 00:00 [received]
PHST- 2018/07/07 00:00 [revised]
PHST- 2018/07/10 00:00 [accepted]
PHST- 2018/08/22 06:00 [pubmed]
PHST- 2018/08/22 06:00 [medline]
PHST- 2018/08/22 06:00 [entrez]
AID - S0161-6420(18)30905-9 [pii]
AID - 10.1016/j.ophtha.2018.07.006 [doi]
PST - ppublish
SO  - Ophthalmology. 2018 Dec;125(12):1929-1936. doi: 10.1016/j.ophtha.2018.07.006.
      Epub 2018 Aug 17.