acute posterior multifocal placoid pigment epitheliopathy
Acute Posterior Multifocal Placoid Pigment Epitheliopathy
A disease of the retinal macula seen in otherwise healthy young patients, who develop bilateral acute onset visual disturbance—e.g., scotomas, blurred vision, red eye or floaters, scintillating scotomas, and hemianopic blur; initial acuity varies widely by site of retinal involvement with one-third of eyes having less than 20/100 when first seen.Aetiology Idiopathic; influenza-like illness.
Systemic defects in APMPPE Erythema nodosum, TB, sarcoidosis, nephritis, thyroiditis, potentially fatal cerebral vasculitis, CSF defects.
Fundoscopy Multiple, yellow-white, flat (placoid) lesions in macula at the level of the retinal pigment epithelium (RPE); lesions are well-circumscribed and discrete; the overlying retina usually appears normal and subretinal fluid is rare; vitritis and iritis are uncommon and mild.
Fluorescein angiography Acute lesions are hypofluorescent, then stain with increasing hyperfluorescence; inactive lesions may fluoresce as window defects due to depigmentation of the RPE.
Prognosis Good; the norm is a rapid regression of the fundus lesions and a delayed return of visual acuity to near normal levels.