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Updated: Apr 16, 2026
Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
PATHOGENESIS OF PERSISTENT PLACOID MACULOPATHY: A Multimodal Imaging Analysis
Melisa Nika1, Partho S Kalyani, K Thiran Jayasundera
1Department of Ophthalmology, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
Purpose:
To describe previously unreported clinical characteristics of persistent placoid maculopathy, suggest a pathogenesis of persistent placoid maculopathy using multimodal imaging, and provide evidence supporting high-dose immunosuppression for short-term management.
Methods:
Retrospective case series.
Results:
The cohort included 3 men with ages ranging from 55 years to 68 years. Persistent placoid maculopathy was bilateral in all 3 patients and characterized by recurrence and choroidal neovascularization in 1 patient. The median time to presentation was 3 months (range, 2-24 months), and follow-up was 8 months (range, 3-24 months). Previously unreported findings of far-peripheral lesions and optic nerve hyperfluorescence on fluorescein angiography were noted in separate individuals. In addition, findings from multimodal imaging supported an inflammatory pathogenesis of the inner choroid and the outer retina. Finally, all patients experienced substantial improvement to structural and functional measures in at least one eye within days to weeks of initiating high-dose corticosteroids (0.75-1 mg/kg/day).
Conclusion:
Multimodal imaging suggests that persistent placoid maculopathy has an inflammatory pathogenesis that may affect the inner choroid with secondary changes to the retinal pigment epithelium and the outer retina. High-dose corticosteroids may provide short-term benefit.
Insights
Persistent placoid maculopathy may stem from inner choroid inflammation. High-dose corticosteroids offer temporary relief for this rare eye condition.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Inflammatory Eye Conditions
Background:
- Persistent placoid maculopathy (PPM) is a rare condition affecting the macula.
- Understanding its pathogenesis and optimal management is crucial for visual preservation.
Observation:
- A retrospective case series of three male patients aged 55-68 with bilateral PPM.
- Previously undocumented findings included far-peripheral lesions and optic nerve hyperfluorescence on fluorescein angiography.
- Recurrence and choroidal neovascularization were observed in one patient.
Findings:
- Multimodal imaging suggested an inflammatory origin within the inner choroid, impacting the retinal pigment epithelium and outer retina.
- All patients showed significant structural and functional improvement within weeks of initiating high-dose corticosteroids (0.75-1 mg/kg/day).
Implications:
- Multimodal imaging supports an inflammatory basis for PPM, potentially originating in the inner choroid.
- High-dose corticosteroids demonstrate short-term efficacy in managing persistent placoid maculopathy.
- Further research into the long-term effects and alternative treatments for PPM is warranted.
