Persistent placoid maculopathy: a new clinical entity.
OBJECTIVE
To describe a previously unreported clinical entity superficially resembling macular serpiginous choroiditis but with a distinct presentation and clinical course.


METHODS
Retrospective observational case series.


METHODS
Six patients, 50 to 68 years old, exhibiting this entity who were seen at 5 different centers from 1984 to 2006.


METHODS
Review of medical records.


METHODS
Best-corrected visual acuity (VA) and clinical and angiographic findings.


RESULTS
The lesions in our patients are similar to those of acute macular serpiginous choroiditis. Our patients had well-delineated whitish plaquelike lesions involving the macula and sparing the peripapillary areas of both eyes. In contrast to serpiginous choroiditis, VA remained good despite early involvement of the fovea until complications related to choroidal neovascularization or pigmentary mottling developed. Angiographic characteristics and the clinical course were also atypical. Fluorescein angiography revealed well-defined early hypofluorescent areas that partially filled in in the late phase. Indocyanine green angiography showed the hypofluorescence to be persistent. Unlike serpiginous choroiditis, the white macular lesions faded over a period of months to years, whereas the characteristic angiographic findings often persisted longer. Choroidal neovascularization developed in 11 of 12 eyes, with subsequent conversion to disciform macular scars in 9 of 12 eyes. Unlike serpiginous choroiditis, none of the eyes showed chorioretinal scar formation unless related to choroidal neovascularization.


CONCLUSIONS
Persistent placoid maculopathy has features resembling macular serpiginous choroiditis but differs in its clinical course and effect on VA. It appears to be a new entity. The majority of eyes develop choroidal neovascularization that results in loss of central vision.
Department of Ophthalmology, Northwestern University, Chicago, Illinois 60611, USA.
Pamela R
PR
Golchet
Lee M
LM
Jampol
David
D
Wilson
Lawrence A
LA
Yannuzzi
Michael
M
Ober
Edward
E
Stroh
D000368:Aged; D020256:Choroidal Neovascularization / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity