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Epidemiology, Associations, and Treatment of Acute Exudative Polymorphous Vitelliform Maculopathy (AEPVM)
Tobin Smith1, Vivian Rajeswaren1, Brittany Hodges1
1Department of Ophthalmology Visual & Anatomical Sciences, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, MI, USA.
Purpose:
Acute Exudative Polymorphous Vitelliform Maculopathy (AEPVM) is a rare retinal disorder characterized by serous subretinal detachments that progress to vitelliform lesions. In this review, we aim to summarize current knowledge of etiologies and treatments for AEPVM and its association with primary and recurrent melanoma.
Methods:
We performed a comprehensive search of scientific literature for articles mentioning Acute Exudative Polymorphous Vitelliform Maculopathy including all literature published through March 2025 using the online electronic databases PubMed, MEDLINE, and Embase.
Results:
We identified 81 cases (mean age 46 ± 16.9 years, 43.2% female) with etiologies including idiopathic (43), infectious (10), paraneoplastic (19), and medication-induced (9). Several successful treatments were identified. Local or systemic corticosteroids in 17 eyes improved subretinal fluid and vision in 100% of idiopathic, 50% of infectious, and 40% of medication-induced cases. In paraneoplastic AEPVM, fluid improved with immunotherapy (2 eyes), chemotherapy (2 eyes), intravitreal methotrexate (1 eye), and aflibercept (2 eyes). Notably, AEPVM was the initial symptom of primary or metastatic melanoma in 5 cases.
Conclusion:
The variable response to treatment and the potential link between AEPVM and primary and recurrent melanoma highlights the need for further research. A thorough understanding of treatment options and outcomes is essential to optimize management and to encourage prompt recognition of metastatic melanoma or other conditions associated with AEPVM.
Insights
Acute Exudative Polymorphous Vitelliform Maculopathy (AEPVM) can be linked to melanoma. Understanding AEPVM causes and treatments is crucial for patient management and early melanoma detection.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Medical Research
Background:
- Acute Exudative Polymorphous Vitelliform Maculopathy (AEPVM) is a rare retinal condition.
- It presents with serous subretinal detachments and vitelliform lesions.
Purpose of the Study:
- To review current knowledge on AEPVM etiologies and treatments.
- To explore the association between AEPVM and melanoma.
Main Methods:
- Comprehensive literature search of PubMed, MEDLINE, and Embase up to March 2025.
- Analysis of 81 identified cases of AEPVM.
Main Results:
- Identified etiologies: idiopathic (43), infectious (10), paraneoplastic (19), medication-induced (9).
- Corticosteroids improved outcomes in idiopathic, infectious, and medication-induced AEPVM.
- Paraneoplastic AEPVM showed varied responses to immunotherapy, chemotherapy, methotrexate, and aflibercept.
- AEPVM preceded primary or metastatic melanoma in 5 cases.
Conclusions:
- Variable treatment responses necessitate further research.
- Recognizing AEPVM is vital for prompt diagnosis of melanoma and other associated conditions.
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