Starry Nights and Fading Vision: PAMM Through the Eyes of a Patient

Introduction Paracentral acute middle maculopathy (PAMM) is characterized by ischemia within the middle retinal layers, typically associated with paracentral scotomas and variable visual outcomes. This case highlights an atypically severe, progressive form of PAMM in an elderly patient with vascular risk factors and a possible infectious trigger. The patientʼs vivid description of visual phenomena, coupled with evolving multimodal imaging findings, provided unique diagnostic and clinical insights into the dynamic course of PAMM and its potential transformation into central retinal vein occlusion (CRVO). Publication History Received: 05 January 2026 Accepted: 12 January 2026 Article published online: 23 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 14, 70469 Stuttgart, Germany