Optical coherence tomography angiography (OCTA) of a 65-year-old man shows an area of flow signal void at the level of the deep capillary plexus (DCP) with corresponding thinning of the inner nuclear layer. This pattern is MOST characteristic of:

• A Paracentral acute middle maculopathy (PAMM) ✓
• B Geographic atrophy of AMD
• C Central serous chorioretinopathy
• D Vitreomacular traction

Explanation

Paracentral acute middle maculopathy (PAMM) results from ischemia of the DCP, producing a flow void at the DCP level on OCTA with subsequent inner nuclear layer thinning on structural OCT — this is its hallmark combination. Geographic atrophy affects the outer retina and RPE. Central serous chorioretinopathy shows subretinal fluid and choroidal abnormalities. Vitreomacular traction produces anterior tractional changes without DCP flow voids.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.