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M. Tonini, A. P. Brezin, D. Monnet; Optical Coherence Tomography in Untreated Patients With Acute Posterior Multifocal Placoid Pigment Epitheliopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3265.
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Optical Coherence Tomography (OCT) analysis may help in the assessment of the primary site of inflammation in Acute Multifocal Posterior Placoid Pigment Epitheliopathy (APMPPE), a disease for which no therapeutic intervention has proven its efficacy. We studied OCT imaging in untreated patients with typical APMPPE at the acute and scarred phases of the disease.
Charts of consecutive patients with typical APMPPE examined between May 2002 and December 2007 in a single referral center were retrospectively reviewed. The diagnosis was based on fundus examination and fluorescein angiography showing bilateral placoid lesions, which were hypofluorescent at the early phase and became hyperfluorescent at the late phases. Best corrected visual acuity (BCVA) fundus photography and OCT images were studied at onset and at day 30 ± 9.
Five Caucasian patients (2 men and 3 women) were included. The age of the patients ranged from 17 to 29 (mean 24.2 ± 4.7 years). At initial examination, the mean of the best corrected visual acuity (BCVA) was 0.54 ± 0.65 LogMAR. OCT confirmed centrofoveal lesions in 8/10 eyes. The mean macular thickness in central 1mm was 330 ± 190 µm, the mean foveal thickness was 304 ± 210 µm and the mean macular volume was 8.5 ± 2.11mm3. In addition to increased retinal thickness, morphological abnormalities included increased backscattering of the outer nuclear layer, retinal serous detachment and partial disruption of the highly reflective third band. At day 30 ± 9, the mean BCVA was 0.11 ± 0.17 LogMAR, the mean macular thickness in central 1mm was 204 ± 24µm, the mean foveal thickness was 170 ± 38µm and the mean macular volume was 7.34 ± 0.43 mm3. An alteration of the highly reflective third band in 5/10 eyes was the only persistent lesion seen by OCT.
The natural course of the disease was favorable in all cases. Although OCT imaging showed consistent abnormalities, the analyses of images could not definitely pinpoint the primary site of inflammation.
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