J.ophthalmol.(Ukraine).2022;5:54-64.
http://doi.org/10.31288/oftalmolzh202255464
Received: 03.08.2022; Accepted: 22.08.2022; Published on-line: 27.10.2022
A case of acute posterior multifocal placoid pigment epitheliopathy: clinical analysis and differential diagnosis
N. V. Konovalova 1, N. I. Khramenko 1, O. V. Guzun 1, S. B. Slobodianyk 1, O. V. Kovtun 2
1 SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine)
2 Odesa National Medical University
Odesa (Ukraine)
TO CITE THIS ARTICLE: Konovalova NV, Khramenko NI, Guzun OV, Slobodianyk SB, Kovtun OV. A case of acute posterior multifocal placoid pigment epitheliopathy: clinical analysis and differential diagnosis. J.ophthalmol.(Ukraine).2022;5:54-64. http://doi.org/10.31288/oftalmolzh202255464
Background: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a rare inflammatory disease, and the differential diagnostic assessment is essential for its adequate treatment.
Purpose: To perform clinical analysis and differential diagnosis for a case of APMPPE.
Material and Methods: We present a case of a 26-year-old woman with APMPPE. The patient underwent an eye examination which included visual acuity assessment, refractometry, tonometry, perimetry, biomicroscopy, direct and indirect ophthalmoscopy, optical coherence tomography (OCT), fundus photography, and fluorescein angiography (FA). Endonasal electrophoresis was conducted in a routine manner using azithromycin, a macrolide antibiotic.
Results: OCT found numerous flat yellowish-white and grey-pink lesions in the posterior pole of the fundus at the level of the retinal pigment epithelium and choriocapillary layers. FA showed irregularly shaped non-fluorescent lesions, which began to exhibit faint fluorescence a few minutes after the dye injection. The differential diagnosis should include serpiginous choroiditis, Vogt-Koyanagi-Harada syndrome, geographical choroiditis, acute retinal pigment epitheliitis (Krill disease), and choroidal neoplasm.
Conclusion: Acute posterior multifocal placoid pigment epitheliopathy is an acute-onset disease. If the disease is suspected, a thorough history is essential, and the differential diagnosis should be performed for early treatment and referral to an appropriate specialist. Patients with this disease should be followed since recurrences can occur.
Keywords: acute posterior multifocal placoid pigment epitheliopathy, differential diagnosis, treatment
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Disclosures
Authour Contribution: Konovalova N V: Conceptualization, Project administration, Data Curation, Formal Analysis, Writing – original draft; Khramenko NI: Conceptualization, Investigation, Writing – review & editing; Slobodianyk SB: Data Curation, Writing – review & editing; Kovtun OV: Writing – original draft, Data Curation.
Conflict of Interest Statement: The authors state that they have no conflict of interest that might bias this work.