CHARACTERIZING PHOTORECEPTOR CHANGES IN ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY USING ADAPTIVE OPTICS.
OBJECTIVE
To characterize lesions of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) by multimodal imaging including adaptive optics scanning laser ophthalmoscopy (AOSLO).


METHODS
We included patients with APMPPE at different stages of evolution of the placoid lesions. Color fundus photography, spectral domain optical coherence tomography, infrared reflectance, fundus autofluorescence, and AOSLO images were obtained and registered to correlate microstructural changes.


RESULTS
Eight eyes of four patients (two women) were included and analyzed by multimodal imaging. Photoreceptor reflectivity within APMPPE lesions was more heterogeneous than in adjacent healthy areas. Hyperpigmentation on color fundus photography appeared hyperreflective on infrared reflectance and on AOSLO. Irregularity of the interdigitation zone and the photoreceptor inner and outer segment junctions (IS/OS) on spectral domain optical coherence tomography was associated with photoreceptor hyporeflectivity on AOSLO. Interruption of the interdigitation zone or IS/OS was associated with loss of photoreceptor reflectivity on AOSLO.


CONCLUSIONS
Irregularities in the reflectivity of the photoreceptor mosaic are visible on AOSLO even in inactive APMPPE lesions, where the photoreceptor bands on spectral domain optical coherence tomography have recovered. Adaptive optics scanning laser ophthalmoscopy combined with multimodal imaging has the potential to enhance our understanding of photoreceptor involvement in APMPPE.
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.|Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Philipp K
PK
Roberts
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Peter L
PL
Nesper
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Alex C
AC
Onishi
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Dimitra
D
Skondra
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Lee M
LM
Jampol
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Amani A
AA
Fawzi
D000208:Acute Disease; D000328:Adult; D002833:Choroiditis / Q000473:pathology*; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D000080364:Multifocal Choroiditis; D009887:Ophthalmoscopy / Q000379:methods*; D055095:Optics and Photonics; D010781:Photography / Q000379:methods*; D017949:Retinal Cone Photoreceptor Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D055815:Young Adult