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Paracentral acute middle maculopathy: precursor to macular thinning in sickle cell retinopathy
  1. Syed Amal Hussnain1,
  2. Patrick A Coady1,2,
  3. Kathleen M Stoessel1
  1. 1 Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA
  2. 2 New England Retina Associates, Hamden, Connecticut, USA
  1. Correspondence to Dr Syed Amal Hussnain,{at}


We present a case of paracentral acute middle maculopathy (PAMM) in a patient with sickle cell disease (SCD). Though gradual capillary loss may contribute to pathophysiology of sickle cell retinopathy as well, our case suggests that PAMM may be the precursor lesion to macular thinning commonly observed in patients with SCD. In addition, fluorescein angiography may be unable to detect these acute vascular events occurring at the deep capillary plexus.

  • Ophthalmology
  • Retina
  • Macula
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  • Contributors All authors made substantial contribution to the conception, design and revision of the draft. KS has followed the patient for a long time in her clinic and was responsible for obtaining the OCT images, FA as well as the consent form. PC and SAH reviewed all the clinical data, compiled it as a case report and reviewed the literature.

  • Competing interests None declared.

  • Patient consent We greatly value our patients’ privacy. Though a consent could not be obtained, we have not included any personal health information or identifiable data in our report that can be traced to the patient. We ensured that all data were anonymised.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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