Paracentral acute middle maculopathy following internal carotid artery stenting.

PURPOSE

To report a case of paracentral acute middle maculopathy (PAMM) that presented after internal carotid artery stenting despite the use of a filter embolic protection device.

OBSERVATIONS

A 74-year-old man presented one week following transfemoral stenting of the right internal carotid artery for high-grade stenosis. A filter-type embolic protection device was used during the stenting procedure to prevent distal embolization of atherosclerotic debris. Dilated examination of the right eye revealed a parafoveal gray lesion in the macula and optical coherence tomography showed a corresponding placoid hyperreflective band at the level of the inner nuclear layer consistent with PAMM. The patient was asymptomatic. At 10 weeks follow up the PAMM lesion was resolved.

CONCLUSIONS

PAMM occurred following internal carotid artery stenting despite the use of a filter embolic protection device, likely due to embolic debris passing through the filter device or debris released while the filter was in a collapsed state. The PAMM lesion was small and resolved without visual sequelae.