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(A) Multicolour image of Case 1 showing the greying of the macula and the presence of dot haemorrhages and hard exudates close to the fovea; (B) SD-OCT image of a horizontal line scan through the fovea showing an early balloon-shaped cyst with a thin hyper-reflective line passing through the ELM and EZ suggestive of a defect. Inner retinal hyper-reflectivity corresponding to the areas of retinal greying also seen; (C) corresponding follow-up SD-OCT showing enlargement of the cyst and defect and the presence of a plume-shaped hyper-reflective substance within the cyst. Inner retinal thinning apparent now; (D) follow-up 2 weeks after the appearance of the plume demonstrating rapid resolution without residual oedema.
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ILM anteriorly and stopped short of the ELM posteriorly (Figure 1). Inner retinal thinning was also noted and a provisional diagnosis of paracentral acute middle maculopathy (PAMM) was made.
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