Abstract
Purpose :
to study a patient affected by acute multifocal placoid pigment epiteliopathy (AMPPE) during the acute stage by a multimodal imaging.
Methods :
a 18-year-old man referred for central scotoma with his decreased central vision OS. He also reported myalgias and fever 2 weeks before the onset of symptoms. His visual was 20/125 OS and 20/20 OD. A complete ophthalmological evaluation was carried out. Fundus photography, fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography (ICG), spectral domain optical coherence tomography (SD-OCT) and adaptive optics (AO) fundus image at the acute stage were also carried out. During the course of the disease and after resolution, SD-OCT and AO were repeated. Both SD-OCT scans and AO were taken through the lesions seen clinically.
Results :
fundus examination in the left eye shown a multiple creamy white placoid lesion located in the foveolar area and at the posterior pole. A similar lesion was also detected in the right eye above the fovea. FA showed early blocking and late staining of the lesions in both eyes with ICG angiography showing hypofluorescence of the lesions throughout the study. FAF imaging revealed area of increased/decreased autofluorescence corresponding to the focal placoid lesions. OCT scans revealed a slight abnormality at the ellipsoidal layer with irregular undulations which got separated from the retinal pigment epithelium layer also becoming more thickened with hypereflectivity. AO of both eyes revealed an island of coarse, hyperrflective speckles surrounded by a dark annulus without any cones. Some islands of normal and well-organized cones cells reappearing in the area of the dark annulus, likely representing an early photoreceptors migration/regeneration during post-acute stages.
Conclusions :
AO allowed direct observation of cone cells abnormality during acute AMPPE demonstrating a superior ability to detect in-depth retinal imaging at the cell level.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.