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Atypical case of acute posterior multifocal placoid pigment epitheliopathy with intraretinal fluid.

Renato Correia BarbosaRita GonçalvesBruna Vieira
Published in: BMJ case reports (2023)
Acute posterior multifocal placoid pigment epitheliopathy is a rare inflammatory chorioretinopathy, classified as a white dot syndrome, in which ischaemia of the choriocapillaris leads to atrophy of the external retinal layers, including the retinal pigment epithelium.A male patient in his 20s presented with sudden severe loss of vision in the left eye. Funduscopy revealed with yellow placoid lesions in the macula and near periphery. Spectral-domain optical coherence tomography and fluorescein angiography revealed the presence of central intraretinal fluid in the left eye and multiple areas of macular ischaemia bilaterally. Treatment with oral corticosteroids was initiated, and the anatomical changes, including the intraretinal fluid, improved steadily over the following weeks.Although rare, the presence of subretinal or intraretinal fluid should not decrease the suspicion of acute posterior multifocal placoid pigment epitheliopathy. Reabsorption of the fluid is usually accompanied by the improvement of the remaining anatomical changes and the visual function.
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