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Acute posterior multifocal placoid pigment epitheliopathy. A follow up study
Abstract:
Thirteen patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) were followed up for a period of from 1 to 20 years (median 5 years 8 months). Five patients developed lesions in the previously unaffected fellow eye during the follow up period. In three patients the condition progressed during a prolonged period without interruption. Widespread severe choroidal atrophy was a late feature in a number of cases. In seven out of thirteen cases, visual acuity remained defective (6/18 or less) in one or both eyes. The prevailing opinion that that APMPPE is self limiting may be incorrect.
Insights
Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) may not be self-limiting. Long-term follow-up revealed persistent progression and visual acuity defects in several patients, challenging previous assumptions.
Area of Science:
- Ophthalmology
- Medical Retina
- Choroid Diseases
Background:
- Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an inflammatory condition affecting the choroid and retinal pigment epithelium.
- The natural history and long-term prognosis of APMPPE are not fully understood, with a common perception of it being self-limiting.
Observation:
- A cohort of thirteen patients with APMPPE was monitored for 1 to 20 years (median 5 years 8 months).
- Disease progression, development of new lesions in the fellow eye, and severe choroidal atrophy were observed during the follow-up period.
- Persistent visual acuity impairment was noted in a significant proportion of patients.
Findings:
- Five patients developed new APMPPE lesions in the contralateral eye.
- Three patients experienced continuous disease progression over extended periods.
- Seven out of thirteen patients (54%) had persistent visual acuity deficits (6/18 or worse) in at least one eye.
- Widespread, severe choroidal atrophy was identified as a late complication in several cases.
Implications:
- The findings challenge the widely held belief that APMPPE is a self-limiting condition.
- Long-term monitoring and management strategies may be necessary for APMPPE patients.
- The potential for chronic progression and irreversible visual impairment necessitates further research into APMPPE pathogenesis and treatment.