{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:45:28Z","timestamp":1792075528706,"version":"4.4.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,14]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To report a case of paracentral acute middle maculopathy (PAMM) in which persistent paracentral dysfunction prompted cardiovascular investigation and diagnosis of severe aortic regurgitation, reduced ejection fraction, and ascending aortic aneurysm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Longitudinal ophthalmic assessment, multimodal retinal imaging, Humphrey SITA Central 10-2 testing, cardiovascular evaluation, surgical findings, histopathology, and targeted aortopathy genetic testing were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A 44-year-old man presented with intermittent right-eye visual disturbance and persistent paracentral scotoma after non-explanatory neuroimaging. Unaided visual acuity remained 20\/25 (6\/7.5; approximately 0.10 logMAR) in each eye, intraocular pressure was 16-19 mmHg, and anterior-segment examination was unremarkable. Multimodal imaging supported PAMM, with structural OCT inner retinal\/inner nuclear layer involvement and qualitative OCT-A\/fluorescein angiographic parafoveal perfusion compromise. The affected inner retinal\/inner nuclear layer region decreased from 45 micrometres to 32 micrometres. Right-eye Humphrey SITA Central 10-2 mean deviation worsened from -3.67 dB on 03 March 2020 to -5.19 dB in February 2026 despite unchanged central acuity. Cardiovascular assessment revealed a 5.5-cm ascending aortic aneurysm, severe aortic regurgitation, and left-ventricular ejection fraction of 49%. The patient underwent elective Bentall procedure, with postoperative ejection-fraction improvement to 55%. No postoperative quantitative OCT-A reperfusion claim is made.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PAMM may warrant systemic cardiovascular assessment when ocular findings do not fully explain persistent paracentral dysfunction. This case supports cautious multidisciplinary evaluation while avoiding unsupported claims of causality, quantitative OCT-A perfusion deficit, or postoperative retinal reperfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/icb.0000000000002002","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:00:10Z","timestamp":1792072810000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Paracentral Acute Middle Maculopathy Prompting Diagnosis of Severe Aortic Regurgitation and Ascending Aortic Aneurysm"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8095-7925","authenticated-orcid":false,"given":"George N.","family":"Palexas","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, North Middlesex University Hospital NHS Trust, Sterling Way, Edmonton, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["RETINAL Cases &amp; Brief Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/ICB.0000000000002002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:00:10Z","timestamp":1792072810000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/ICB.0000000000002002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1097\/icb.0000000000002002","relation":{},"ISSN":["1935-1089","1937-1578"],"issn-type":[{"value":"1935-1089","type":"print"},{"value":"1937-1578","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]}}}