Acute, posterior multifocal placoid pigment epitheliopathy: a case of 11 recurrences over 15 years.
OBJECTIVE
To report the case of a patient with recurrent, acute posterior multifocal placoid pigment epitheliopathy. To the best of our knowledge, this is the longest documented course with the greatest number of recurrences reported.


METHODS
Observational case report of one patient. A 27-year-old otherwise healthy male patient presented with recurrence of new scotomata over 15 years. Fundus photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence, and optical coherence tomography documented his clinical course.


RESULTS
Over the course of 15 years, the patient developed 11 symptomatic (5 imaging-documented) recurrences of acute, posterior multifocal placoid pigment epitheliopathy affecting both eyes. Each episode manifested with new subjective scotomata and new lesions noted on imaging. Symptoms mostly resolved after each episode, and visual outcome remained excellent (20/20 in the right eye and 20/25 left eye at the last follow-up).


CONCLUSIONS
Although typically monophasic, acute posterior multifocal placoid pigment epitheliopathy can rarely present with a recurrent course over a prolonged period of time and should be considered as a diagnosis in patients presenting with recurrent visual symptoms and new placoid lesions on imaging. In recurrent cases, visual recovery may still remain excellent.
*Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and †Department of Ophthalmology, Medical University Vienna, Vienna, Austria.
Liza M
LM
Cohen
Marion R
MR
Munk
Debra A
DA
Goldstein
Lee M
LM
Jampol
D000208:Acute Disease; D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D012008:Recurrence; D012164:Retinal Diseases / Q000175:diagnosis*; D012607:Scotoma / Q000175:diagnosis*; D013997:Time Factors