Acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

This rare condition usually occurs in young adults causing vision loss in both eyes. Treatment includes high doses of steroids. Symptoms may include flashes of light, blurred vision, blind spots, and distorted vision. Fundus examination shows scattered, flat multifocal creamy white or yellow spots at the level of the retinal pigment epithelium (RPE) with indistinct margins.


Source: Review of Ophthalmology

Figure 1. Acute posterior multifocal placoid pigment epitheliopathy. A) Color fundus photograph showing placoid lesions in the macula and periphery of the left eye. B and C) Fluorescein angiogram of the same patient three months prior demonstrating early hypofluorescence (B) and late staining (C) of the lesions. D) SD-OCT showing lesion with irregular thickening of the retinal pigment epithelium and patchy loss of the ellipsoid zone and RPE layers. E) On fundus autofluorescence, active lesions are hypoautofluorescent due to a blocking effect by the outer retinal lesions, but with resolution develop a hyperautofluorescent rim thought to be secondary to altered RPE metabolism and lipofuscin deposition.

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