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[Acute multifocal placoid pigment epitheliitis of the retina (author's transl)]
Abstract:
Two cases of acute, multifocal, placoid, pigment epitheliitis, are described. In acute multifocal placoid pigment epitheliopathy (AMPPE) visual acuity falls precipitously, accompanied by whitish, confluent, blurry lesions of the posterior pole retina. On fluorescein angiography, these lesions characteristically block the normal choroidal flush. Visual acuity improves over a period of months, in spite of heavy residual chorioretinal scarring. In acute pigment epitheliitis, visual acuity also drops suddenly, but the objective findings are limited to slight depigmentation of the foveal area, especially visible in early stages of fluorescein angiography. Vision improves over a period of weeks. These diseases of the retinal pigment epithelium must be correctly diagnosed, since their visual prognosis is far better than that of central chorioretinitis or other macular diseases.
Insights
Acute multifocal placoid pigment epitheliopathy (AMPPE) and acute pigment epitheliitis cause sudden vision loss. AMPPE shows retinal lesions and improves over months, while epitheliitis has milder foveal changes and resolves in weeks.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pigment Epithelium Disorders
Context:
- Acute, multifocal, placoid, pigment epitheliitis presents diagnostic challenges.
- Distinguishing between similar retinal pigment epithelium conditions is crucial.
Purpose:
- To describe two cases of acute pigment epitheliitis.
- To differentiate acute multifocal placoid pigment epitheliopathy (AMPPE) from acute pigment epitheliitis based on clinical and angiographic findings.
Summary:
- AMPPE involves sudden visual acuity loss with whitish, confluent posterior pole retinal lesions, which block choroidal flush on fluorescein angiography. Recovery occurs over months despite scarring.
- Acute pigment epitheliitis presents with sudden vision drop and minimal foveal depigmentation, visible on early fluorescein angiography. Vision improves within weeks.
- Both conditions affect the retinal pigment epithelium but have distinct prognoses.
Impact:
- Accurate diagnosis of these pigment epitheliitis conditions is vital for patient prognosis.
- Correctly identifying these entities ensures appropriate management and patient counseling, highlighting a better visual outcome compared to other macular diseases.