Spectral domain optical coherence tomography and autofluorescence in a case of acute posterior multifocal placoid pigment epitheliopathy mimicking vogt-koyanagi-harada disease: Case report and review of literature

Grant E. Lee, Brandon W. Lee, Narsing A. Rao, Amani A. Fawzi

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Purpose: To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) with exudative retinal detachment, simulating acute Vogt-Koyanagi-Harada (VKH) disease and to review relevant imaging literature. Methods: Ophthalmologic examination, laboratory evaluation, fluorescein angiography, and B-scan ultrasonography performed at baseline, as well as spectral domain optical coherence tomography (OCT) and fundus autofluorescence performed upon initial presentation and at 5-day, 1-month, and 3-month follow-up. Results: OCT demonstrated outer retinal hyperreflectance and subretinal fluid in the acute phase that disappeared 5 days later. Choroidal thickening was noted on OCT and ultrasonography. Retinal pigment epithelium lesions were hypoautofluorescent acutely but became hyperautofluorescent later in the disease course. Conclusions: At presentation, there can be considerable overlap in both clinical and imaging findings in APMPPE mimicking acute VKH, making it difficult to differentiate these two entities. Cerebral spinal fluid analysis and follow-up examinations could help in arriving at proper diagnosis.

Original languageEnglish (US)
Pages (from-to)42-47
Number of pages6
JournalOcular Immunology and Inflammation
Volume19
Issue number1
DOIs
StatePublished - Feb 2011

Keywords

  • Vogt-Koyanagi-Harada disease
  • acute posterior multifocal placoid pigment epitheliopathy
  • autofluorescence
  • optical coherence tomography

ASJC Scopus subject areas

  • Immunology and Allergy
  • Ophthalmology

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