Acute Idiopathic Maculopathy

Ghazi, Nicola G.; Daccache, A.; Conway, Brian

doi:10.1016/j.ophtha.2006.08.055

Cited by 14 publications

(13 citation statements)

References 5 publications

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“…Based on these similar imaging findings, we hypothesized that coxsackievirus could also play a potential role in triggering an immune-mediated response leading to APMPPE based on these similar choroidal inflammatory processes. In addition, recent studies have shown that the extended spectrum of UAIM may also include bilateral disease [25].…”

Section: Introductionmentioning

confidence: 99%

Long-term multimodal imaging in acute posterior multifocal placoid pigment epitheliopathy and association with coxsackievirus exposure

Palejwala

Shantha

et al. 2020

PLoS ONE

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The purpose of this study was to evaluate potential insights into the pathogenesis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) using multimodal diagnostic imaging and laboratory evaluation in long-term follow-up. A retrospective, single-center case series was conducted on seven consecutive patients (14 eyes) who were given a diagnosis of APMPPE from March 1, 2011, through June 30, 2019 with at least three months of follow-up. Clinical characteristics (age, symptoms, visual acuity [VA]), laboratory testing including coxsackievirus titers, and multimodal imaging from fundus photography, spectraldomain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), fluorescein angiography (FA), and indocyanine green angiography (ICG) were analyzed for each patient. The initial median VA was 20/71 and final median VA was 20/22. Coxsackievirus B (CVB) titers were elevated (� 1:80) in six of seven patients, with a four-fold increase in convalescent titers seen in two patients suggestive of recent infection. All patients were treated with oral corticosteroids, and five patients underwent corticosteroid-sparing immunomodulatory therapy. Initially, multifocal deep choroidal lesions were observed in the posterior pole corresponding to patches of hypocyanescence on ICG. Overlying retinal pigment epithelium (RPE) disease was observed on FAF, although this finding was not universally observed, suggesting that RPE disease may occur as a sequelae to unchecked choroidal inflammation. SD-OCT architectural changes confirmed outer retina and ellipsoid zone disruption. FA of active lesions showed early hypofluorescence and late hyperfluorescence with surrounding leakage while inactive disease showed areas of staining. Long-term follow-up of multimodal diagnostic imaging in APMPPE revealed that choroidal inflammation likely precedes RPE change and photoreceptor damage. Elevation of coxsackievirus titers with seroconversion may be associated with an infectious trigger in concert with immune-mediated disease in this posterior uveitis syndrome.

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Section: Introductionmentioning

confidence: 99%

Long-term multimodal imaging in acute posterior multifocal placoid pigment epitheliopathy and association with coxsackievirus exposure

Palejwala

Shantha

et al. 2020

PLoS ONE

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“…Choroidal neovascularization may occur as a consequence of the retinal pigment epithelial disturbance leading to permanent severe loss of vision. Other features of UAIM may include vitreous cells, papillitis, punctate intraretinal hemorrhages, eccentric macular lesions, subretinal exudation, macular hole, and bilaterality [1][2][3][4][5][6][7][8][9][10][11][12][13]. Association with viral prodrome, pregnancy, human immunodeficiency virus, toxoplasmosis, and Coxsackie virus has been reported, but the pathophysiology of UAIM is not fully understood.…”

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confidence: 99%

Transient electro-oculogram impairment in unilateral acute idiopathic maculopathy

et al. 2009

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Unilateral acute idiopathic maculopathy (UAIM) is a rare distinct entity characterized by acute exudative maculopathy occurring in young persons. The purpose of this case study is to report transient electro-oculogram (EOG) impairment during the acute stage of UAIM. A 16-year-old healthy female with UAIM in the left eye underwent serial visual field, fluorescein angiography, indocyanine green angiography, full-field electroretinogram (ERG), and EOG. Initial visual acuity of the affected left eye was 4/200 with macular subretinal exudates. Indocyanine green angiography disclosed early phase foveal hypocyanescence persisting into late phase along with late phase foci of pinpoint hypocyanescence scattered in the macular and mid-peripheral regions. Standard full-field ERG responses performed 18 days after the onset of symptoms were normal. Standard EOG revealed a marked reduced light-peak to dark-trough amplitude ratio (Arden ratio) of 1.20 left eye (normal >or= 1.7) and a normal ratio of 2.24 right eye. Five weeks later, the left eye improved to 20/50, and the exudative maculopathy resolved with residual irregular foveal hyperpigmentation. Repeat EOG performed 69 days after onset of symptoms showed recovery and normalization of the EOG amplitude ratio of the left eye from 1.20 to 2.54. Transient EOG impairment with a normal full-field ERG may occur during the early stage of UAIM. This finding suggests a more widespread dysfunction of the retinal pigment epithelium in at least some cases of UAIM.

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“…Gupta et al [5] reported a patient with a prominent serous macular detachment, but the fluorescein angiogram of this patient was not characteristic of UAIM, because it lacked the characteristic early hypofluorescence and hyperfluorescence and late hyperfluorescence described in this condition. Ghazi et al [4] also described an atypical case characterized by a macular hole in one eye and a small extrafoveal serous detachment of the neurosensory retina in the fellow eye. This case also lacked the hyperfluorescence pattern in the angiogram.…”

Section: Discussionmentioning

confidence: 99%

“…The condition is considered to be idiopathic, although a possible association with Coxsackie virus was hypothesized [3]. In most cases, the involvement is unilateral, but bilateral lesions have also been reported [2,4].…”

Section: Discussionmentioning

confidence: 99%

“…A Medline search identified only seven cases of UAIM evaluated using OCT [4][5][6][7][8][9][10]. Gupta et al [5] reported a patient with a prominent serous macular detachment, but the fluorescein angiogram of this patient was not characteristic of UAIM, because it lacked the characteristic early hypofluorescence and hyperfluorescence and late hyperfluorescence described in this condition.…”

Section: Discussionmentioning

confidence: 99%

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Optical Coherence Tomography Findings in a Case of Unilateral Acute Idiopathic Maculopathy

Andonegui¹,

Maya²,

Zurutuza³

et al. 2012

OJOph

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Purpose: To describe the clinical, angiographic, and Optical Coherence Tomography (OCT) findings in a patient with Unilateral Acute Idiopathic Maculopathy (UAIM) and to discuss a possible pattern of OCT findings in patients with this disease. Methods: Case report. Results: A 34-year-old man with UAIM was evaluated. During the acute phase fundus examination revealed a yellow thickening in the macular area of the right eye, Fluorescein Angiography (FA) showed early alternating patches of hypofluorescence and hyperfluorescence and late hyperfluorescence and OCT showed thickening of the outer retina in the foveal zone. Six weeks later, the macula had pigmentary mottling, FA showed an area of central hypofluorescence surrounded by a hyperfluorescent ring that remained unchanged during the angiogram and the OCT examination was normal. Conclusion: OCT is a useful diagnostic tool for UAIM. OCT evaluation of patients with this disease will exhibit the heterogeneous hyperreflectivity and thickening of the outer retina and Retinal Pigment Epithelium (RPE). A serous macular detachment may not be a prominent finding in UAIM.

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Acute Idiopathic Maculopathy

Cited by 14 publications

References 5 publications

Long-term multimodal imaging in acute posterior multifocal placoid pigment epitheliopathy and association with coxsackievirus exposure

Long-term multimodal imaging in acute posterior multifocal placoid pigment epitheliopathy and association with coxsackievirus exposure

Transient electro-oculogram impairment in unilateral acute idiopathic maculopathy

Optical Coherence Tomography Findings in a Case of Unilateral Acute Idiopathic Maculopathy

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