A Case of Bilateral Acute Posterior Multifocal Placoid Pigment Epitheliopathy – Atypically with Monocular Subretinal Macular Fluid – in an Adolescent Female Patient and Resolving without Treatment

Introduction

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a form of inflammatory chorioretinopathy and can be associated with cerebral vasculitis [1], [2].

Gass was the first to describe APMPPE [3]. It occurs in young adulthood, with an average presentation age of 27 years and affects men and women about equally [4]. The estimated incidence is 0.15 cases per 100 000 [5]. APMPPE is characterized by multiple yellow to white lesions in the posterior pole of the macula, typically in both eyes [6]. Viral symptoms often precede this condition [6]. The exact cause of APMPPE remains unknown. Initially, it was thought to be a change in the retinal pigment epithelium (RPE), but nowadays it is seen as an immune-mediated condition, possibly triggered by an infection or linked to autoimmune conditions [4].

The lesions often resolve spontaneously [7], typically resulting in good visual recovery [8], but complete recovery is not assured in all cases [9]. Treatment with corticosteroids can be considered. Although there is no consensus in the literature regarding this approach, it is recommended for cases with foveal involvement [2].

The purpose of this paper is to report a conservatively managed case of bilateral APMPPE in a very young patient, presenting with atypical monocular subretinal fluid (SRF) with foveal involvement, accompanied by visual impairment.

Publication History

Received: 25 November 2024

Accepted: 06 February 2025

Article published online:
27 March 2025

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