title: Spectral domain optical coherence tomography classification of acute posterior multifocal placoid pigment epitheliopathy.
abstract: OBJECTIVE
  To study the retinal morphologic changes occurring in acute posterior multifocal placoid pigment epitheliopathy using spectral domain optical coherence tomography.
  
  
  METHODS
  Prospective observational case series of 12 eyes (6 consecutive patients) diagnosed with acute posterior multifocal placoid pigment epitheliopathy. All patients underwent complete ophthalmologic examination, fundus photography, fluorescein angiography, and spectral domain optical coherence tomography at the initial visit. During follow-up, ophthalmologic examination and spectral domain optical coherence tomography scans were performed. The scans were directed to the lesions observed on the clinical examination and fluorescein angiography.
  
  
  RESULTS
  Spectral domain optical coherence tomography classification containing four distinct stages for acute posterior multifocal placoid pigment epitheliopathy is proposed. Stage 1 demonstrates a dome-shaped elevation with disruption of the photoreceptor junction that flattens shortly after. Stage 2, occurring 2 weeks later, demonstrates distinct separation between the photoreceptor junction and the retinal pigment epithelium (RPE). Stage 3, visible 6 weeks post disease initiation, demonstrates accentuated RPE hyperreflectivity and union of the RPE and photoreceptor junction. Stage 4, the resolution phase, starts at 3 months demonstrating reformation of 2 distinct visible layers of photoreceptors and RPE.
  
  
  CONCLUSIONS
  The morphologic retinal findings in acute posterior multifocal placoid pigment epitheliopathy visible by the spectral domain optical coherence tomography occur in the outer retina, mainly the photoreceptors and RPE. Most findings reached nearly complete resolution and were correlated with improvement in visual acuity.
authors.affiliation: Department of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. dafnagoldenberg@gmail.com
authors.forename: Dafna
authors.initials: D
authors.lastname: Goldenberg
authors.forename: Zohar
authors.initials: Z
authors.lastname: Habot-Wilner
authors.forename: Anat
authors.initials: A
authors.lastname: Loewenstein
authors.forename: Michaella
authors.initials: M
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012164:Retinal Diseases / Q000145:classification* / Q000175:diagnosis; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult