Acute Exudative Polymorphous Vitelliform Maculopathy Associated With Primary Epstein–barr Virus Infection

Lentzsch, Anna; Dooling, Vivienne; Wegner, Ina; Cristanziano, Veronica Di; Sadda, Srinivas R; Freund, K. Bailey; Liakopoulos, Sandra

doi:10.1097/icb.0000000000001066

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…However, three of 18 patients had a preexisting infectious condition, such as hepatitis C (1 patient) or HIV (2 patients). 8 The occurrence of AEVPM was also reported in patients with Lyme disease 9 and primary Epstein–Barr virus infection, 10 and although an autoimmune mechanism has been suggested, its etiology is still unellucidated. 4…”

Section: Discussionmentioning

confidence: 99%

Full title: Acute Exudative Polymorphous Vitelliform Maculopathy as the initial presentation of Human Immunodeficiency Virus Infection

Niegowski

Rachiq²,

Amoroso³

et al. 2022

RETINAL Cases &Amp; Brief Reports

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Purpose: To describe the occurrence of acute exudative polymorphous vitelliform maculopathy as the initial presentation in a HIV-positive patient.Methods: Observational case report of one patient and literature review.Results: An active 21-year-old white woman presented to the emergency department with anterior segment complaints. Her best-corrected visual acuity was 20/20 in both eyes. Fundus examination revealed numerous, polymorphous, bleb-like lesions at the posterior pole, corresponding, on structural imaging (optical coherence tomography) to subretinal detachments. The bleb-like lesions on infrared imaging were slightly autofluorescent on fundus autofluorescence. Swept-source optical coherence tomography angiography showed signal attenuation because of the presence of subretinal fluid in the choriocapillaris segmentation. Multimodal imaging findings were suggestive for acute exudative polymorphous vitelliform maculopathy. Hence, a systemic blood workup was performed. The workup returned positive for HIV, and an antiviral therapy was introduced. Conclusion:The fortuitous diagnosis of HIV having as the initial presentation acute exudative polymorphous vitelliform maculopathy in an asymptomatic patient highlights the value of a thorough clinical examination and multimodal imaging in correctly diagnosing this rare disorder and its cause. This case report could prove helpful to clinicians faced with this rare scenario.

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Section: Discussionmentioning

confidence: 99%

Full title: Acute Exudative Polymorphous Vitelliform Maculopathy as the initial presentation of Human Immunodeficiency Virus Infection

Niegowski

Rachiq²,

Amoroso³

et al. 2022

RETINAL Cases &Amp; Brief Reports

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“…In the earlier stages of its discovery, the disease was believed to be exclusively paraneoplastic; however, it has since been reported with melanomas 8 as well as viral diseases. 9 It is typically characterized by transient visual symptoms and headache followed by multifocal exudative lesions, elongated photoreceptor outer segments, and subsequent formation of vitelliform deposits. Continuous RPE failure leads to lipofuscin accumulation and the emergence of yellow deposits that appear hyperautofluorescent on FAF.…”

Section: Discussionmentioning

confidence: 99%

Covid-19 Vaccine–induced Acute Exudative Polymorphous Vitelliform Maculopathy: Case Reports

Baddar

Fayed

Tawfik

et al. 2024

RETINAL Cases &Amp; Brief Reports

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Background: Acute exudative polymorphous vitelliform maculopathy is a presumed retinal pigment epithelium abnormality that has been reported in patients with neoplasms and under certain classes of drugs. The pathophysiology remains unclear, despite the typical clinical features.Purpose: To report two cases of acute exudative polymorphous vitelliform maculopathy occurring after vaccination with a COVID-19 vaccine.Case Reports: Two adult patients presented with visual disturbance after inoculation with a COVID-19 vaccine. The patients were otherwise healthy and have no family history of retinal dystrophies. Both cases exhibited the following features on multimodal imaging: multifocal hyporeflective lesions involving the macula, elongated photoreceptors, accumulated vitelliform material exhibiting autofluorescence, and lack of fluorescein dye leakage. Evidence of retinal pigment epithelium dysfunction was confirmed by electrooculography.Conclusion: Two cases of acute exudative polymorphous vitelliform maculopathy occurring after COVID-19 vaccination were reported. A relationship between the vaccine and the retinal pigment epithelial abnormality development that led to acute exudative polymorphous vitelliform maculopathy was postulate, possibly through autoantibodies against the severe acute respiratory syndrome coronavirus 2 virus structural surface glycoprotein antigens that cross react with the normal retinal pigment epithelial cells.

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“…It is worth mentioning that AEPVM was reported to occur with other infectious etiologies such as syphilis, Lyme, human immunodeficiency virus, and Epstein–Barr virus infection. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

“…It has also been reported to occur with infectious diseases or as an idiopathic process. [ 5 ] However, the exact mechanism of disease is not entirely understood. On multimodal imaging, vitelliform lesions usually exhibit early blockage and late staining in fluorescein angiogram.…”

Section: Introductionmentioning

confidence: 99%

Coronavirus Disease 2019-induced Acute Exudative Polymorphous Vitelliform Maculopathy

Osman,

Mehana,

Eissa

et al. 2022

Middle East African Journal of Ophthalmology

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Acute exudative polymorphous vitelliform maculopathy (AEPVM) is a rare entity characterized by acute multifocal macular detachment with polymorphous subretinal vitelliform deposits. The disease is a presumed retinal pigment epithelial dysfunction and is reported to occur with malignancies. We report a case of a 32-year-old otherwise healthy woman who presented with an acute bilateral visual disturbance a few days after testing positive for coronavirus disease 2019 (COVID-19). Her initial visual acuity was 6/6 in both eyes. Fundus examination revealed bilateral multifocal round yellowish subretinal deposits. Spectral-domain optical coherence tomography showed bilateral foveal serous retinal detachment with subretinal hyperreflective materials consistent with vitelliform deposits. Systemic workup to exclude malignancies and genetic diseases was unremarkable. The patient was observed without treatment, and the vitelliform materials gradually resolved over 18 months of follow-up. In our era of the global pandemic, AEPVM may be associated with COVID-19 infection.

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Acute Exudative Polymorphous Vitelliform Maculopathy Associated With Primary Epstein–barr Virus Infection

Cited by 6 publications

References 16 publications

Full title: Acute Exudative Polymorphous Vitelliform Maculopathy as the initial presentation of Human Immunodeficiency Virus Infection

Full title: Acute Exudative Polymorphous Vitelliform Maculopathy as the initial presentation of Human Immunodeficiency Virus Infection

Covid-19 Vaccine–induced Acute Exudative Polymorphous Vitelliform Maculopathy: Case Reports

Coronavirus Disease 2019-induced Acute Exudative Polymorphous Vitelliform Maculopathy

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