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Acute macular neuroretinopathy (AMN) has been characterized as wedge-shaped superficial retinal defects in the macula, resulting in paracentral scotomas. It has been associated with vasoconstrictors and sympathomimetics.1 In 2013, paracentral acute middle maculopathy (PAMM) was described as an AMN variant, seen as a hyperreflective band involving the middle retinal layers on spectral-domain optical coherence tomography (SD-OCT).1 Type 1 PAMM lesions involve layers above the outer plexiform layer (OPL), reflecting superficial or intermediate capillary plexus occlusion; type 2 lesions involve layers below the OPL, affecting the deep capillary plexus.1
Pecen PE, Smith AG, Ehlers JP. Optical Coherence Tomography Angiography of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy. JAMA Ophthalmol. 2015;133(12):1478–1480. doi:10.1001/jamaophthalmol.2015.4100