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.

Fig. 1

Color photographs and fluorescein angiography of APMPPE associated with SRF: Case 1. A, Multiple placoid subretinal lesions are scattered throughout the posterior pole bilaterally. Two of the lesions that correspond to those showed in Figure 2B are labeled with an asterisk (*). Subretinal fluid was noted clinically in both eyes. B, Fluorescein angiography showed early blockage of the subretinal lesions. C, Late staining of subretinal lesions is also noted.

Fig. 2

Optical coherence tomography showing bilateral sub-foveal detachments in patients with APMPPE. A, At presentation, the patient had decreased vision associated with SRF in the right eye. B, In the left eye, the patient had either intraretinal fluid or SRF (X). The more hyperreflective material at the edge of this space corresponds to the location of the “white dots” (*). C and D, The fluid had resolved in both eyes by 1 week after presentation.

Fig. 3

Color fundus photograph and OCT of the right eye: Case 2. A, The color fundus photograph shows multiple placoid subretinal lesions and SRF in the macula. B, Optical coherence tomography of the right eye with SRF and adjacent intraretinal fluid. The subretinal hyperreflective area (Δ) corresponds to the white dot in A.