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Laura Kueny, David Spinak; Case Report of Acute Posterior Multifocal Placoid Pigment Epitheliopathy in a 13 Year Old Male. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2035.
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© ARVO (1962-2015); The Authors (2016-present)
To report a case of Acute Posterior Multifocal Placoid Pigment Epitheliopathy in a young healthy male patient with Native American ancestry.
Case report describing the presentation and findings of Acute Posterior Multifocal Pigment Epitheliopathy in this patient. Information regarding this patient was collected from Retina Center Northwest in Silverdale Washington.
The patient is a 13 year old male that noticed sudden onset of central blurry vision in his right eye that started two weeks prior to presentation. On the initial visit his visual acuity was 20/25 in the right eye, 20/20 in the left eye and his dilated exam and Optical coherence tomography (OCT) showed findings consistent with subretinal fluid of the right eye. Fluorescein Angiography of the right eye demonstrated early blockage and late leakage in the macula, in addition to late staining of the macula and optic nerve head. Indocyanine Green Angiography in the right eye demonstrated significant blockage in the macula consistent with inflamed retinal pigment epithelium (RPE). In the left eye ICG also demonstrated early blockage in the macula consistent with inflamed RPE. Subsequent infectious and autoimmune work up performed on the patient at that time was negative.
This case represents a unique presentation of Acute Posterior Multifocal Placoid Pigment Epitheliopathy in a young patient of Native American ancestry. There is significant macular edema and blockage of blood flow of the macula in both eyes that is not consistent with the minimal decrease in his visual acuity in the right eye, and no change in vision in his left eye. In conclusion, this slight change in visual acuity could have easily gone undetected by the patient or nonspecialized clinician. It is known that Acute Posterior Multifocal Pigment Epitheliopathy is associated with cerebral vasculitis, therefore missing this diagnosis in younger populations presenting with minimal visual symptoms could be detrimental.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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