“…The classical numerous hyperfluorescent pinpoints appeared successively and could correspond to a leakage of fluorescein through focal alterations of the RPE. These FA findings are in agreement with those reported earlier, which suggested a delayed choroidal filling in VKH disease based on FA findings in the early phase [7][8][9]. The alterations of RPE could be induced by the choroidal hypoperfusion, as has been shown in humans by angiography [7][8][9] and experimentally in animals [10,11].…”
“…The classical numerous hyperfluorescent pinpoints appeared successively and could correspond to a leakage of fluorescein through focal alterations of the RPE. These FA findings are in agreement with those reported earlier, which suggested a delayed choroidal filling in VKH disease based on FA findings in the early phase [7][8][9]. The alterations of RPE could be induced by the choroidal hypoperfusion, as has been shown in humans by angiography [7][8][9] and experimentally in animals [10,11].…”
“…APMPPE has always been considered an inflammatory condition, with most authors favoring choriocapillaris occlusion as the cause of the color change in the RPE and the early angiographic findings [1][2][3]6].…”
APMPPE shows outer retinal layers changes on OCT, which resolve totally after subsidence of the acute phase. AF shows areas of increased fluorescence after resolution, with near normal return of function on microperimetry.
“…There remains the question of whether the vasculitic process, which is considered the cause of the placoid lesions, first affects the RPE or the choriocapillaris [20][21][22]. Supporters of both hypotheses hotly debate the interpretation of fluorescein angiography and, although some reports have described abnormal choroidal perfusion that favours the choroid as the primary site of involvement, the question will probably remain open until histopathological evidence is available.…”
Section: Discussionmentioning
confidence: 99%
“…The polymorphism of APMPPE makes differential diagnosis between this disorder and related clinical entities rather difficult and is responsible for the tendency to classify this condition within the group of the so-called 'white dot syndromes', non-granulomatous choroiditis, which have certain clinical similarities and include serpiginous peripapillary choroiditis, acute retinal epithelitis, multiple evanescent white dot syndrome, and multifocal choroiditis (pseudo-POHS) [9]. That abnormal choroidal perfusion and focal retinal epithelial infarction may be common features of all these fundus diseases cannot be excluded [10] and it has been suggested that diseases within this spectrum are all manifestations of varying degrees of choroidal ischaemia [11,12].…”
Acute posterior multifocal placoid pigment epitheliopathy is a non-granulomatous chorioretinitis of uncertain origin that occurs in healthy young adults. The prevailing opinion is that the disease has a good long-term prognosis for visual acuity because it is self-limiting and chorioretinal scars do not enlarge with time. A middle-aged adult male who had acute posterior multifocal placoid pigment epitheliopathy in one eye has been followed for 22 years. After apparent clinical healing of the placoid epithelial lesions, widespread severe choroidal atrophy with visual loss occurred and progressed over years without interruption. To our knowledge this is the second report of progressive deterioration of a supposedly self-limiting chorioretinal disease.
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