Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy

Acute macular neuroretinopathy (AMN) and paracentral acute middle maculopathy (PAMM) are two entities that share many similarities and can be difficult to distinguish on funduscopic examination. Patients with these entities will usually present with discrete, well-defined paracentral scotomas as their only visual symptom and can share certain risk factors. Although the scotomas may improve, subtle visual defects may persist long-term. Notably, ancillary imaging technologies such as infrared imaging and spectral-domain optical coherence tomography are essential for diagnosing AMN and PAMM as well as differentiating the two conditions. AMN and PAMM have been active areas of research as the pathophysiologic processes have not been fully elucidated. Management of AMN and PAMM is nonspecific and consists mainly of treatment of underlying conditions and amelioration of risk factors. The natural history of both entities results in characteristic chronic changes in the retinal architecture.