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Waseem Ansari, Kimberly Baynes, Francesco Pichi, Ashleigh Laurin Levison, Careen Y Lowder, Sunil K Srivastava; Optical Coherence Tomography Angiography (OCTA) Findings in Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE). Invest. Ophthalmol. Vis. Sci. 2016;57(12):4506.
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© ARVO (1962-2015); The Authors (2016-present)
APMPEE is an inflammatory chorioretinopathy that presents with sudden but transient visual loss associated with bilateral yellow-white placcoid lesions. The aim of this study is to describe optical coherence tomography angiography findings during the various stages of acute posterior multifocal placoid pigment epitheliopathy.
A total of 10 eyes among 5 patients with diagnosed APMPPE were photographed and imaged by color retinal photographs, fluroscein angiography (FA), indocyanine green angiography (ICG), spectral domain optical coherence tomography (SD-OCT), and OCTA. The OCTA features at the levels of choriocapillaris, deep retina, and inner retina were characterized and correlated to findings on convential imaging modalities.
Ten eyes among five patients (3 females and 2 males; mean age 31.6) presented with development of decreased visual acuity and the presentation of posterior pole yellow white placcoid lesions. Two cases were imaged at presentation, two after 1-2 months of high dose prednisone treatment, and one after two years without activity. En face OCTA imaging demonstrated normal vasculature at the superficial and deep retina, but had areas with loss of flow at the level of choriocapillaris which loosely correlated to the locations of hyperfluorescence on late FA and hypofluorescence on ICG. The defects on OCTA were much smaller and less diffuse, and occasionally normal in areas that were abnormal on FA and ICG. OCTA flow loss improved in patients with resolution of the lesions. Small areas of OCTA flow loss persisted in patients with previous disease. Cross sectional imaging demonstrated loss of ellipsoid zone in patients with decreased visual acuity in active disease, and changes at the level of the RPE.
OCTA revealed vascular deficiencies at various depths in the choriocapillaris in patients with APMPPE at different stages.This study demonstrates that with further characterization and standardization, OCTA may be beneficial in evaluating patients with APMPPE for disease diagnostics, progression, and treatment response.
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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