DEMOGRAPHICS AND CLINICAL FEATURES IN SERPIGINOUS CHOROIDOPATHY AND ACUTE MULTIFOCAL PLACOID PIGMENTED EPITHELIOPATHY (AMPPE)

Abstract

Purpose: To describe the clinical features and outcomes of a large group of patients with a spectrum of clinical appearances and diagnosed as having Serpiginous Choroidopathy (SC) or Acute Multifocal Placoid Pigmented Epitheliopathy (AMPPE).

Methods: In a retrospective consecutive case series, patients seen during a 12-year period at Moorfields Eye Hospital who were diagnosed as having SC or AMPPE were included. Main outcome measures included initial and final visual acuity, laterality, sparing of the peripapillary area, development of choroidal neovascularization (CNV), number of flare ups during follow up. Statistical significance for intergroup differences was assessed by Mann-Whitney’s U test and Fisher’s test.

Results: A total of 43 patients (86 eyes), 16 (32 eyes) with serpiginous choroidopathy and 27 (54 eyes) with AMPPE were included. The average age was 37.7 years; 49.3 years in the SC group, and 30.9 in the AMPPE group (p=0.001). 24/43 patients (55.8%) were male; 7/16 (46.67%) males in the SC group and 17/27 (60.71%) males in the AMPPE group (p=0.341). The overall mean follow-up was 3.79 years. Thirty-two patients had bilateral disease, 13 bilateral SC, 19 bilateral AMPPE (p=0.494). Mean initial visual acuity 20/30 in all patients (20/40 SC, 20/25 AMPPE) (p=0.003). The mean final visual acuity was 20/25 (20/40 SC, 20/20 AMPPE) (p=0.000). 4 patients with SC, compared to non with AMPPE developed CNV (4.7%) (p=0.017). The mean number of flare ups during the follow up period was 0.67 in all patients, 0.88 for SC, and 0.55 for AMPPE (p=0.003).

Conclusions: A large group of patients with serpiginous choroidopathy and AMPPE were reviewed. Different clinical findings and visual outcomes were found between both groups. AMPPE has a better visual outcome, affecting younger patients, less flare ups during the follow-up and lack of associated CNV. These finding suggest a different underlying etiopathology for SC and AMPPE.

Keywords: 452 choroid • 557 inflammation • 688 retina