Subretinal Fluid in Acute Posterior Multifocal Placoid Pigment Epitheliopathy

Abstract

Purpose The purpose of this study was to describe the clinical finding of macular subretinal fluid by optical coherence tomography in patients with acute posterior multifocal placoid pigment epitheliopathy. Methods Patients with acute posterior multifocal placoid pigment epitheliopathy were identified, and those with macular serous retinal detachment noted clinically and confirmed by optical coherence tomography are described. Results Of 8 patients with acute posterior multifocal placoid pigment epitheliopathy evaluated by the uveitis service at the Illinois Eye and Ear Infirmary between 2003 and 2008, 4 eyes of 3 patients presented with macular subretinal fluid. Confirmatory optical coherence tomography was performed in two patients. Conclusion Acute posterior multifocal placoid pigment epitheliopathy may present clinically with macular subretinal fluid. This finding can be confirmed and monitored with optical coherence tomography.

Optical coherence tomography imaging in uveitis

“…Garg and Jampol observed similar lesion backscattering on TD OCT in a patient with APMPPE and serous macular detachments [118]; however, UHR OCT demonstrated more clearly that these lesions were located in the outer retina [117]. The presence of serous macular detachment and intraretinal fluid has been further demonstrated in APMPPE [119][120][121]. Birnbaum et al [119] showed the presence of macular subretinal fluid on OCT in two of eight patients with APMPPE.…”

“…The presence of serous macular detachment and intraretinal fluid has been further demonstrated in APMPPE [119][120][121]. Birnbaum et al [119] showed the presence of macular subretinal fluid on OCT in two of eight patients with APMPPE. Lee et al [120] reported on a patient with acute APMPPE mimicking VKH disease.…”

“…Photoreceptor disruption leading to hyperreflectivity in the photoreceptor layer above RPE and underlying backscattering [115][116][117][118][122][123][124][125] Alterations in the outer retinal layers including the external limiting membrane, IS/OS junction, and OS/RPE (COST) junction line [120] Subretinal fluid or large intraretinal cysts in the outer nuclear layer in some patients [118][119][120][121] Recovery…”

Spectral Domain Optical Coherence Tomography Classification of Acute Posterior Multifocal Placoid Pigment Epitheliopathy

“…[13][14][15][16] Optical coherence tomography (OCT) enables noncontact and noninvasive imaging of the retina and can be repeated frequently. Retinal changes in APMPPE demonstrated by the time domain OCT (10-mm resolution) were described so far only in four cases, [17][18][19][20] and another small series on three patients used the ultra-high-resolution OCT (3 mm resolution). 21 Major advances in both imaging speed and sensitivity have been achieved with the introduction of spectral domain optical coherence tomography (SD-OCT), yielding unprecedented images with improved resolution single frames, better OCT fundus image, and mapping of individual retinal layers.…”

Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE): A Case Report

“…4,5 The characteristic feature of the early phase of APMPPE hypofluorescence is considered secondary to either blocking of background choroidal fluorescence or choroidal hypoperfusion. 6 Our patient did not complain of headaches, hearing problems, or abnormal skin sensations, although these symptoms do not always accompany VKH disease.…”