Choroidal ischemia drives macular neovascularization in persistent placoid maculopathy

Area of Science:

• Ophthalmology
• Medical Imaging

Background:

• Persistent placoid maculopathy (PPM) is an inflammatory condition affecting the macula.
• Choroidal ischemia is a key feature of PPM, potentially leading to complications.

Observation:

• A case study of a 65-year-old man with unilateral decreased vision and characteristic macular lesions is presented.
• Sequential optical coherence tomography angiography (OCTA) revealed persistent inner choroidal ischemia correlating with PPM.
• Macular neovascularization (MNV) developed in areas of prior ischemia despite immunosuppressive therapy.

Findings:

• OCTA effectively visualizes persistent inner choroidal ischemia in PPM.
• Ischemic areas in PPM can serve as a substrate for the development of MNV.
• Serial anti-VEGF therapy was required to manage the induced MNV.

Implications:

• OCTA is crucial for diagnosing and monitoring PPM and its complications.
• Understanding the link between choroidal ischemia and MNV in PPM is vital for patient management.
• This case highlights the potential for neovascularization in previously ischemic macular regions.