title: A syndrome resembling acute posterior multifocal placoid pigment epitheliopathy in older adults.
abstract: OBJECTIVE
  To describe clinical characteristics and visual and anatomic outcomes of a syndrome in older patients that is similar in its active stage to acute posterior multifocal placoid pigment epitheliopathy, but has a distinct clinical course.
  
  
  METHODS
  We retrospectively reviewed medical records and photographic studies of consecutive patients over the age of 50 who presented with acute-onset visual symptoms associated with flat, gray-white lesions at the level of the retinal pigment epithelium reminiscent of acute posterior multifocal placoid pigment epitheliopathy.
  
  
  RESULTS
  The cohort included four men and two women with a median age of 72.5 (range, 58-82) years. The disease course was characterized by recurrent episodes in 6 (55%) of 11 eyes, with initial or eventual bilaterality in all five binocular patients. Five of six patients were treated with corticosteroids and all six patients experienced significant short-term improvement in visual acuity. However, 8 (73%) of 11 eyes developed progressive geographic atrophy and 7 (64%) developed choroidal neovascularization. With a mean (+/-SD) follow-up time of 6.6 +/- 5.5 years, the final visual acuity was 20/200 or worse in 8 (73%) of 11 eyes.
  
  
  CONCLUSIONS
  Although older patients presenting with acute posterior multifocal placoid pigment epitheliopathy-like lesions are likely to experience visual improvement as acute lesions resolve, geographic atrophy and choroidal neovascular membrane formation may subsequently develop, leading to moderate or severe visual loss.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Taich
authors.forename: Mark W
authors.initials: MW
authors.lastname: Johnson
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000188:drug therapy; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012164:Retinal Diseases / Q000175:diagnosis* / Q000188:drug therapy; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D012607:Scotoma / Q000175:diagnosis* / Q000188:drug therapy; D013577:Syndrome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids