Acute Posterior Multifocal Placoid Pigment Epitheliopathy With Associated Papillitis

Abstract

The purpose of this study was to report the rare presentation of bilateral acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and unilateral papillitis treated successfully with corticosteroid therapy. The methods used in this study include fundus photography and fluorescein angiography.A 40-year-old female presented to the emergency room with decreased vision, headache, and photophobia with fundus examination findings of bilateral creamy placoid lesions in the posterior pole and unilateral papillitis, macular edema, and disc hemorrhages. Fluorescein angiography demonstrated early hypofluorescence corresponding to the placoid lesions followed by late, irregular hyperfluorescent staining. Optical coherence tomography revealed peripapillary and macular edema of the left eye. The patient was treated with two retrobulbar corticosteroid injections and a course of oral prednisone with improvement in fundus findings and visual acuity at follow-up examination six weeks from the presentation. The presence of optic nerve and macular edema in APMPPE suggests severe chorioretinal inflammation for which systemic and local corticosteroids are a reasonable treatment option.

The characteristics of white dot syndromes following COVID-19 Vaccines: a systematic review

“…Multifocal yellowish-white, deep retinal, small and larger dots were seen in the posterior pole and extended beyond the arcades. FAF showed multiple scattered hyperautofluorescent spots: OS revealed a generalized reduction and paracentral islands of sensitivity loss Covishield 2 1 Low-grade fever and pain at the injection site following the first as well as second dose of the vaccine Conrady et al ([ 26 ] David et al [ 36 ] OS Retinal thickening and edema of outer retinal layers more nasally, optic nerve extensive thickening of RNFL Slit lamp (OS Flare, OD + 1 vitreous cells, OU trace cell, + 2 nuclear sclerotic cataract) Fundoscopy (Multiple non coalescing creamy colored placoid lesions throughout posterior pole, OS severe papillitis and superior disc hemorrhages with surrounding retinal edema), Brain MRI (contrast enhancement within posterior aspect of left globe at optic nerve sheath insertion) Pfizer-BioNTech 1 14 NA David et al [ 36 ] De Salvo et al [ 37 ] Outer nuclear layer thinning and ellipsoid zone disruption OU Normal The dilated fundus exam showed subtle, bilateral, pigmentary changes in the central maculae. Near-infrared reflectance revealed hyporeflective lesions in the maculae OU.…”