Migraine Followed Shortly by Paracentral Acute Middle Maculopathy: A Case Report of 2 Patients

Paracentral acute middle maculopathy (PAMM) is hypothesized as an ischemia of watershed regions of the superficial and deep capillary plexuses within the inner nuclear layer of the retina (1). Through an unknown mechanism, migraine patients may have retinal microvascular changes, including enlarged foveal avascular zones and decreased capillary vessel density (2). The relationship between migraines and PAMM has limited investigation. We report 2 cases of patients with migraine episodes shortly preceding the development of monocular paracentral scotomas with correlated ocular coherence tomography (OCT) middle macular layer losses.