PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH BRANCH RETINAL ARTERY OCCLUSION DUE TO POLYCYTHEMIA IN A PATIENT WITH TETRALOGY OF FALLOT

Purpose To describe the occurence of paracentral acute middle maculopathy (PAMM) associated with branch retinal artery occlusion (BRAO) secondary to polycythemia in a patient with tetralogy of Fallot. Methods Case report. Results A 30-year-old male presented with acute vision loss and superior visual deficit in his left eye for two days. His medical record had a tetralogy of Fallot (TOF). Complete blood count showed red blood cell count of 9.88 million/uL (4.4-5.6), hemoglobin of 17.7 g/dL (13.5-16.9), and hematocrit of 65.4 % (40-49). The best-corrected visual acuity was 20/25 in the left eye and a diagnosis of left inferotemporal branch retinal artery occlusion was made. Spectral domain optical coherence tomography revealed a characteristic hyperreflective band-like lesion on the inner nuclear layer consistent with PAMM. Conlusion Polycythemia may be a trigger for BRAO associated PAMM. We suggest a new precursor cause of PAMM which is previously undescribed.