Clinical Outcomes of Observed and Treated Acute Posterior Multifocal Placoid Pigment Epitheliopathy and Relentless Placoid Chorioretinitis

Figures & data

Figure 1. Posterior pole scanning laser ophthalmoscopy appearance. Cases 1–12 at the time of acute lesions for each eye or at the earliest presentation.

Figure 2. Comparison of presenting retina lesion areas and retinal lesions post-presentation in untreated and treated cases.

Table 1. Cohort characteristics.

Case	Age (yrs)	Sex	Disease Entity	Lesion Type – BALAD/Non-BALAD/NSD	Bilateral	Time to second eye involvement (wks)/Order	Preceding Corticosteroids	Treatment	Follow-up (wks)	Foveal Involved	BCVA on Presentation	BCVA at 6 months or nearest assessment
1	20	M	APMPPE	Non-BALAD	N	OS only	N	Nil	26.7	N	20/30 OD, 20/30 OS	20/13 OD, 20/13 OS
2	21	F	RPC	Non-BALAD	Y	8/OS-OD	Y^a	Prednisolone, IVMP,ATT, Azathioprine	35.7	OU	20/20 OD, 20/60 OS	20/20 OU
3	21	F	APMPPE	Non-BALAD	N	OS only	Y^b	Nil	30.4	N	20/20 OD, 20/20 OS	20/17 OD, 20/17 OS
4	23	M	APMPPE	BALAD, Non-BALAD and NSD OU	Y	OU at presentation	N	Nil	32.1	OU	20/200 OD, 20/60 OS	20/20 OU
5	24	F	APMPPE	Non-BALAD	Y	OU at presentation	N	Prednisolone	44.1	N	20/17 OD 20/13 OS	20/17 OU
6	26	M	APMPPE	Non-BALAD OD /BALAD and Non-BALAD OS	Y	OU at presentation	N	Prednisolone	22.4	OU	20/120 OD, 20/17 OS	20/20 OD, 20/30 OS
7	27	F	APMPPE	Non-BALAD OD/BALAD and Non-BALAD OS	Y	OU at presentation	N	Prednisolone	20.7	OS	20/17 OD, 20/200 OS	20/20 OD, 20/25 OS
8	31	F	APMPPE	Non-BALAD	Y	OU at presentation	N	Nil	40.8	OU^c	20/600 OD, 20/20 OS	20/20 OD, 20/17 OS
9	35	M	APMPPE	Non-BALAD	Y	OU at presentation	N	Prednisolone	30	OS	20/25 OD, 20/30 OS	20/17 OU
10	35	M	APMPPE	Non-BALAD	N^d	OD only	N	Prednisolone	27.2	OD	20/32 OD, HM OS^d	20/32 OD, HM OS^d
11	49	M	RPC	BALAD and Non-BALAD OU	Y	OU at presentation	ND	Prednisolone, IVMP, Acyclovir	26.1	OU	20/80 OD, 20/60 OS	20/40 OD, 20/40 OS
12	57	F	APMPPE	Non-BALAD	Y	OU at presentation	ND	Prednisolone	26	OD	20/25 OD, 20/32 OS	20/32 OD, 20/25 OS

APMPPE = Acute posterior multifocal placoid pigment epitheliopathy; ATT = Anti-tuberculous therapy; BALAD = Bacillary layer detachment; HM = Hand movements; IVMP = Intravenous Methlyprednisolone; N = No; ND = Not documented; Non BALAD = No evidence of bacillary layer detachment; NSD = Neurosensory detachment; OD = Right eye; OS = Left eye; OU = Both eyes; Wks = Weeks; Y = Yes; Yrs = Years; RPC = Relentless placoid chorioretinitis.

^aPreceding oral prednisolone 2 weeks prior to onset for lower respiratory tract infection.

^bPatient on budesonide/formoterol fumarate dihydrate inhaler for asthma.

^cOD vision reduced due to the involvement of pre-retinal hemorrhage.

^dOS dense amblyopia.

Figure 3. Affected eye, worst visual acuity to visual acuity at 6 months or nearest acuity assessment. Arrows indicate the change from worst visual acuity to final visual acuity during the study period. a = Vision reduced due to the involvement of pre-retinal hemorrhage.

Figure 4. Case 2 left eye, ultra-widefield retinal imaging. A. Left eye appearance at presentation. B. Left eye appearance 14 days following the initiation of a reducing course of oral prednisolone, commenced at 60 mg a day. C. Left eye appearance at 37 days post-3 daily 1 g intravenous methylprednisolone doses.