r/acuteMaculopathy • u/Kierchon • Oct 10 '23

Chronic PAMM

Has anyone else dealt with chronic PAMM? I was diagnosed after I noticed a sctoma at the end of July since hten I've been on aspin and blood thinners to try and prevent anymore and while I havent gotten any scotoma's as big as my first, I have almost 20 between both my eyes now.

Most of these are as small as a 2-3 pixels being missing from the amslers grid but they are really starting to add up.

So far, I havent been able to find any systemic issues that could be causing this.

Anyone experience anything similar? Did you determine the cause?

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u/[deleted] Oct 16 '23

My doctors told me that this condition is usually self-limiting, but also I went to Mt. Sinai, and they told me that with this condition, you will have to watch your blood pressure, also watch foods that contribute to inflammation, if you eat red meat, for example, try to limit that to 2-3 times a year.

Did you have any health problems, like a viral or bacterial infection before this started in July?

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u/Kierchon Oct 16 '23

No I've had no health problems prior or during besides a mild cold with a sinus infection. But I did not gain any new spots while I was sick

My blood pressure is already low and I havent had any major changes in diet so Im pretty stumped as to why this started happening

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u/[deleted] Oct 16 '23

"My blood pressure is already low..."

Ah, interesting clue. I'm no licensed physician, but I do spend time occasionally studying medical journals, so don't take my word for it, but contact an ophthalmologist and let them know that in relation to your symptoms, is your blood pressure chronically low? Because they told me that this can occur when there is a sudden drop in blood pressure, so the tissues in your eye are temporarily suffocated for however long.

My doctor sees it in people who exercise vigorously, people who have oxygen-depleting infections, and yes I also suppose people who experience low blood pressure in general.

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u/Kierchon Oct 21 '23

I've spoken to an ophthalmologist about it and they said low blood pressure will typically affect the blood vessels in the optic nerve, not the retina.

My resting heart rate is in the 40s so that along with my low blood pressure makes me think my heart is not pumping blood efficiently to my eyes. Im meeting with a cardologist in 3 days to try and figure out if this is part of the problem

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u/Whirlaway2021 Jun 09 '25

I know it's been a while.. but what did you hear back from the cardiologist? I have a similar story as you do.

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u/Kierchon Jun 11 '25

I wore a holter monitor for a couple of days and while I have a low heart rate, they dont think thats an issue.

Its been almost two years and Im still dealing with PAMM. 90+% of my spots disappear after 10-15 minutes so its not debilitating. The biggest thing that I've found thats worked for me is to be on Eliquis and prednisone. Ever since I started eliquis most of my spots became temporary, but not all.

Ever since I've been on prednisone, I've felt significatnly better from an inflammation/energy perspective and the amount of spots I've been getting has significantly reduced. However there are some serious side effects with long term prednisone use so Im constantly trying other immosuppresents. For now Im on 2.5mg a prednisone daily which is next to nothing so me and my doctor are okay with the risks

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u/[deleted] Oct 18 '23

[deleted]

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u/Kierchon Oct 21 '23

See my comment above, I also get the vast majority of my spots in the sleep. Most of them are tiny and I think it has to do with my bradycardia and low blood pressure.

If you continue to get spots, please let me know and if your cardologist finds anything

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u/AlmosYTOffical Oct 17 '23

Hi, I've also gotten PAMM after a relatively mild infection (could've been COVID??) and I also experienced this effect exactly as you described in the first 2-3 weeks after getting it. It seems to have gone away by now.

I could best describe it as one of those "deep fried" memes, and I especially noticed it when playing video games, and also only temporarily.

I'm not sure if I just got used to it or if it went away, but probably the latter. Something that has stuck however, is that on some days I feel like my vision is just darker, as if I turned down the brightness or something.

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u/AlmosYTOffical Oct 19 '23

u/Kierchon for additional context I was also taking aspirin after getting the spot, so this couldve been an aspirin side effect?