CASE REPORT article
Front. Neurol.
Sec. Neuro-Ophthalmology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1698882
Paracentral Acute Middle Maculopathy with Cerebral Infarction Caused by Carotid Dissection: A Case Report
Provisionally accepted
- 1West China Hospital, Sichuan University, Chengdu, China
- 2Huize County People's Hospital, Qujing, China
- 3West China Hospital of Sichuan University, Chengdu, China
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Introduction: Paracentral acute middle maculopathy (PAMM) is related to retinal capillary ischemia, occurring independently or secondary to systemic diseases. We report an unusual case of PAMM with cerebral infarction caused by carotid dissection without systemic risk factors. Case Description: A 55-year-old man presented with acute painless left visual loss and partial sensory aphasia, followed by right-sided weakness. Best-corrected visual acuity (BCVA) was 0.04 in the left eye. Optical coherence tomography (OCT) showed hyperreflective lesions at the OPL-INL junction; enface imaging revealed fern-like hyperreflective lesions in the inner nuclear layer (INL). OCT angiography (OCTA) demonstrated diffuse macular hypoperfusion. Brain MRI showed left basal ganglia infarction, and angiography confirmed left internal carotid artery (ICA) dissection and near occlusion. After carotid stenting and dual-antiplatelet therapy, BCVA improved to 0.8 at 3 months with OCTA-confirmed retinal reperfusion. Conclusions: This is a report that links PAMM and cerebral infarction to carotid dissection, suggesting that PAMM should prompt urgent stroke and carotid workup in appropriate clinical context.
Keywords: paracentral acute middle maculopathy, Cerebral Infarction, carotiddissection, Optical Coherence Tomography, Ischemic cascade
Received: 04 Sep 2025; Accepted: 15 Oct 2025.
Copyright: © 2025 Tang, Liu, Cao, Liu and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huiqiong Tang, 153262439@qq.com
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