PATHOGENESIS OF PERSISTENT PLACOID MACULOPATHY: A Multimodal Imaging Analysis.
OBJECTIVE
To describe previously unreported clinical characteristics of persistent placoid maculopathy, suggest a pathogenesis of persistent placoid maculopathy using multimodal imaging, and provide evidence supporting high-dose immunosuppression for short-term management.


METHODS
Retrospective case series.


RESULTS
The cohort included 3 men with ages ranging from 55 years to 68 years. Persistent placoid maculopathy was bilateral in all 3 patients and characterized by recurrence and choroidal neovascularization in 1 patient. The median time to presentation was 3 months (range, 2-24 months), and follow-up was 8 months (range, 3-24 months). Previously unreported findings of far-peripheral lesions and optic nerve hyperfluorescence on fluorescein angiography were noted in separate individuals. In addition, findings from multimodal imaging supported an inflammatory pathogenesis of the inner choroid and the outer retina. Finally, all patients experienced substantial improvement to structural and functional measures in at least one eye within days to weeks of initiating high-dose corticosteroids (0.75-1 mg/kg/day).


CONCLUSIONS
Multimodal imaging suggests that persistent placoid maculopathy has an inflammatory pathogenesis that may affect the inner choroid with secondary changes to the retinal pigment epithelium and the outer retina. High-dose corticosteroids may provide short-term benefit.
Department of Ophthalmology, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
Melisa
M
Nika
Partho S
PS
Kalyani
K Thiran
KT
Jayasundera
Grant M
GM
Comer
D000368:Aged; D004596:Electroretinography; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D012164:Retinal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
D005938:Glucocorticoids; D011241:Prednisone