Paracentral acute middle maculopathy in the immediate postoperative of cataract surgery

ABSTRACT This case report identified paracentral acute middle maculopathy as the cause of severe and irreversible vision loss after cataract surgery. Cataract surgeons should be aware of known risk factors for the development of paracentral acute middle maculopathy. In those patients, extra care regarding anesthesia, intraocular pressure, and some other aspects of cataract surgery must be taken. Paracentral acute middle maculopathy is currently understood as a clinical sign evident on spectral-domain optical coherence tomography, and it is probably evidence of deep ischemic insult to the retina. It should be a differential diagnosis in cases of marked low vision acuity associated with no fundus abnormalities in the immediate postoperative period, as demonstrated in the presented case.

摘要 本病例报告明确了中心旁急性中层黄斑病变（paracentral acute middle maculopathy）是白内障术后严重且不可逆视力丧失的致病原因。白内障手术医师应警惕该病变发生的已知危险因素，针对此类患者，需在麻醉、眼压及白内障手术的其他若干环节中格外谨慎。目前学界认为，中心旁急性中层黄斑病变是一种可在光谱域光学相干断层扫描（spectral-domain optical coherence tomography）下观测到的临床体征，其本质大概率为视网膜深层缺血性损伤。在术后即刻出现显著低视力但眼底无异常的病例中，该病变应作为鉴别诊断之一，本报告所呈现的病例即印证了这一点。