Sudden Vision Loss: What an Eye Scan Can and Can't Tell
By MS Buddy ·
Summarized from American journal of ophthalmology, Oct 2026 · PubMed. AI-generated summary. Not medical advice.
Research by Sanjana Molleti, Michael Lee and 9 colleagues at the University of Minnesota, Minneapolis, Johns Hopkins University School of Medicine and 2 other institutions in the United States.
Key Takeaway
For sudden vision loss, a certain eye-scan finding can raise concern about a serious blood-vessel problem, but its absence cannot rule that problem out.
What They Found
Researchers reviewed eye scans from 119 people over age 50 who had sudden vision loss caused by poor blood flow to the nerve that connects the eye to the brain. Twenty-seven had a form linked to artery inflammation, and 92 had a form not linked to artery inflammation. A finding called PAMM, which shows damage to part of the light-sensing layer at the back of the eye, appeared in about 19% of the inflammation group and 5% of the other group. In other words, the finding was uncommon in both groups, but more common when artery inflammation was involved. Because it appeared in only about one in five people with the inflammation-linked form, a scan without PAMM could not safely rule it out.
Who Should Care and Why
This study did not test people specifically for MS, but sudden vision changes matter to anyone living with MS. MS can also affect the nerve that connects the eye to the brain, so it is important not to assume a new vision problem is caused by MS. If you have sudden vision loss, seek urgent medical care rather than waiting for your next MS appointment. Tell the clinician when the change started and that you have MS; this helps them look for the right cause. Eye specialists may use the scan as one clue, like a piece of a puzzle, alongside your symptoms and other tests.
Important Considerations
The study looked back at records from three medical centers and included only 27 people with the inflammation-linked form, so the results may not apply to everyone. It included people over 50 who had an eye scan within 14 days of symptoms, not people of all ages or those scanned later. PAMM sometimes appeared without artery inflammation, so patients and caregivers should not treat one scan finding as a diagnosis.
AI-generated summary — for informational purposes only, not medical advice
Read the original abstract
Published in American journal of ophthalmology by et al.. Reproduced from the PubMed record.
The purpose of this study was to evaluate the diagnostic accuracy of paracentral acute middle maculopathy (PAMM) detected on optical coherence tomography (OCT) macula for differentiating arteritic anterior ischemic neuropathy (AAION) from nonarteritic anterior ischemic optic neuropathy (NAION) in a multicenter United States cohort. Retrospective, multicenter diagnostic accuracy analysis. This study included patients diagnosed with AAION or NAION at the University of Minnesota, Mayo Clinic, and Johns Hopkins Wilmer Eye Institute between January 2020 and January 2025. Inclusion criteria consisted of patients older than 50 years who had obtained OCT macula within 14 days of symptom onset. AAION diagnoses were confirmed by temporal artery biopsy or positron emission tomography/computed tomography. Two masked fellowship-trained neuro-ophthalmologists independently evaluated OCT images for the presence of acute PAMM. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PAMM for AAION were calculated. A total of 119 patients were included, consisting of 27 patients with AAION and 92 patients with NAION. PAMM was identified in 18.5% of patients with AAION and 5.4% of patients with NAION (p = 0.032). The sensitivity, specificity, PPV, and NPV of PAMM for AAION was 19% [95% CI: 0.08-0.37], 94.6% [95% CI: 0.88-0.98], 50% [95% CI: 0.24-0.76], and79.8% [95% CI: 0.71-0.86] respectively. Three of five NAION patients with PAMM had provoked NAION associated with severe systemic hypoperfusion. PAMM is a highly specific but insensitive OCT marker for AAION. Although its presence should increase clinical suspicion for AAION, PAMM may rarely occur in patients with NAION particularly in the setting of systemic hypoperfusion and should be interpreted within the overall clinical context.
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