Purpose: 

To report the occurrence of paracentral acute middle maculopathy (PAMM) in giant cell arteritis (GCA), describe its features and outcomes, and identify risk factors associated with PAMM in patients with GCA.

Methods: 

Review of medical records of patients with GCA who were examined in the Rothschild Foundation Hospital. Patients were divided into three groups: GCA with PAMM (Group 1), GCA with ophthalmic involvement but without PAMM (Group 2), and GCA without ophthalmic involvement (Group 3). We analyzed the data for age, sex, medical history, laboratory testing, visual acuity, and posterior segment vascular involvement.

Results: 

Among the 96 patients who met the inclusion criteria, 52 had ophthalmic involvement, and 16 patients were included in Group 1 (GCA with PAMM). In this subgroup, the mean age was 81.6 years and was found to be older than other groups. The visual prognosis was similar between Groups 1 and 2. Of the 20 eyes with PAMM, 35% were also associated with homolateral anterior ischemic optic neuropathy. No statistical difference was found in initial symptoms, signs, and laboratory testing.

Conclusion: 

Paracentral acute middle maculopathy is frequently observed lesions in ocular GCA. Patients can present with isolated findings of PAMM as the only indication of GCA. Optical coherence tomography of the macula should be routinely performed in patients with suspected GCA, specifically if they complain of visual changes, to look for signs of ischemia in the middle layers of the retina. Isolated PAMM should raise suspicion for GCA in patients at risk.

中文翻译：

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巨细胞性动脉炎的中央旁急性中间黄斑病变

目的： 

报告巨细胞动脉炎 (GCA) 中旁中央急性中间黄斑病变 (PAMM) 的发生情况，描述其特征和结果，并确定 GCA 患者中与 PAMM 相关的危险因素。

方法： 

审查在罗斯柴尔德基金会医院接受检查的 GCA 患者的医疗记录。将患者分为三组：有 PAMM 的 GCA（第 1 组）、有眼部受累但没有 PAMM 的 GCA（第 2 组）和没有眼部受累的 GCA（第 3 组）。我们分析了年龄、性别、病史、实验室检查、视力和后段血管受累的数据。

结果： 

在符合纳入标准的 96 名患者中，52 名有眼部受累，16 名患者被纳入第 1 组（GCA 与 PAMM）。在这个亚组中，平均年龄为 81.6 岁，并且比其他组更老。第 1 组和第 2 组的视觉预后相似。在 20 只 PAMM 眼中，35% 还与同侧前部缺血性视神经病变有关。在初始症状、体征和实验室检测中未发现统计学差异。

结论： 

在眼部 GCA 中经常观察到旁中央急性中间黄斑病变。患者可以将 PAMM 的孤立发现作为 GCA 的唯一指征。疑似 GCA 的患者应常规进行黄斑光学相干断层扫描，特别是如果他们抱怨视觉变化，以寻找视网膜中层缺血的迹象。孤立的 PAMM 应引起高危患者对 GCA 的怀疑。