Acute idiopathic maculopathy. Report of five cases

To describe the clinical features, multimodal imaging findings, and follow-up of five patients with acute idiopathic maculopathy.

This was a retrospective study including five patients diagnosed with acute idiopathic maculopathy. Clinical variables assessed included age, sex, presenting symptoms, ophthalmological examination of both eyes including visual acuity, funduscopic findings and diagnostic tests (optical coherence tomography, optical coherence tomography angiography, autofluorescence and fluorescein angiography). Treatment received and disease course were also documented.

Five patients were included in the study (three male and two female) with a mean age of 37.2 years (range, 13-57years). All patients presented with a sudden decrease in visual acuity. The most characteristic funduscopic finding was a yellowish-gray macular lesion; small satellite lesions were observed in all patients, and fellow eye involvement was observed in three patients. SD-OCT demonstrated disruption of the outer retinal layers; FAF showed variable autofluorescence, hypo- and/or hyperautofluorescence; OCT-A revealed reduced choriocapillaris flow signal in the early stages with subsequent recovery; and FAF demonstrated initial hypofluorescence followed by irregular hyperfluorescence over time.

Acute idiopathic maculopathy is an entity with a favorable prognosis, characterized by partial recovery of affected structures. Initially described as a unilateral disease, there are bilateral and multifocal forms that should be considered.