Acute posterior multifocal placoid pigment epitheliopathy: outcome and visual prognosis.
OBJECTIVE
To examine the clinical outcomes and the effect of treatment in patients with acute posterior multifocal placoid pigment epitheliopathy.


METHODS
Cases of acute posterior multifocal placoid pigment epitheliopathy treated at the Massachusetts Eye and Ear Infirmary from 1990 to 2002 and cases from the literature were identified. Data on visual acuity, ocular symptoms, bilateral involvement, foveal involvement at presentation, and treatment regimens were recorded.


RESULTS
Visual acuity was 20/25 or worse in 226 (76.6%) eyes and 20/40 or worse in 172 (58.3%) eyes at presentation. At the last follow-up visit, visual acuity was 20/25 or less in 125 (42.3%) eyes and 20/40 or less in 70 (23.7%) eyes. Topical or systemic therapy was given in nearly half of the cases (54.4%). Overall, 87 (71.9%) eyes were symptomatic at last follow-up visit. Finally, measured visual acuity was more than 20/25 in 20 (87.5%) eyes without foveal involvement at presentation and in 28 (39.2%) eyes with foveal involvement.


CONCLUSIONS
Although acute posterior multifocal placoid pigment epitheliopathy shows a relatively benign prognosis, especially when compared with some of the other white dot syndromes, there are patients who experience incomplete visual recovery.
Fiore
Tito
T
Department of Ophthalmology, Cornell University, New York, USA.
Iaccheri
Barbara
B
Androudi
Sofia
S
Papadaki
Thekla G
TG
Anzaar
Fahd
F
Brazitikos
Periklis
P
D'Amico
Donald J
DJ
Foster
C Stephen
CS
D000208:Acute Disease; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000037:antagonists & inhibitors; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007275:Injections, Intravenous; D008297:Male; D011379:Prognosis; D020127:Recovery of Function; D012164:Retinal Diseases / Q000188:drug therapy* / Q000503:physiopathology*; D055213:Retinal Pigment Epithelium; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents