Photoreceptor atrophy in acute posterior multifocal placoid pigment epitheliopathy demonstrated by optical coherence tomography

Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
Retina (Impact Factor: 3.24). 01/2006; 25(8):1109-12. DOI: 10.1097/00006982-200512000-00027
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    • "Our patient also showed foveal retinal detachment, which was first reported by Birnbaum et al. [3] who described the first series of APMPPE cases with foveal detachment. Thus far, OCT findings of APMPPE have shown that the outer nuclear layer, external limiting membrane, and the IS/OS line are disrupted [2, 3, 6, 7, 8, 9, 10] and that serous retinal detachment occurs with or without intraretinal cystic space formation. Although hyperreflective debris or deposits were reportedly observed in the subretinal fluid or intraretinal cystic space [2, 3, 8], to our knowledge, our case is the first to report disruption of the membranous layers in the intraretinal cystic space. "
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    ABSTRACT: We report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE), which was difficult to differentiate from posterior pole-type Vogt-Koyanagi-Harada (VKH) disease because the lesions were mainly located in the macula bilaterally. A 33-year-old man presented with rapid bilateral loss of vision. Fundoscopy revealed yellow-white subretinal lesions in the posterior pole of both eyes. Optical coherence tomography (OCT) revealed the presence of subretinal fluid with a subretinal septum. After initiation of systemic steroids, OCT revealed that the amount of subretinal fluid decreased immediately. However, vision loss was less responsive to the therapy, and OCT revealed partial reorganization of the inner segment/outer segment (IS/OS) line in the bilateral macular areas after therapy. In our case, the location of the macular lesions made it difficult to differentiate APMPPE from VKH disease by fluorescein angiography. OCT images showed VKH disease-like findings of serous retinal detachment with a subretinal septum. The outer nuclear layer disappeared and the IS/OS line in the affected area was disorganized in the acute stage of the disease. In this case, the rapid loss of vision was specific to the onset pattern of APMPPE, and the slow response to therapy was very different from the response typically observed in VKH disease. Thus, careful consideration of the clinical course is important for diagnosing APMPPE.
    Case Reports in Ophthalmology 10/2013; 4(3):172-179. DOI:10.1159/000356051
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    ABSTRACT: The authors report a case of typical acute posterior multifocal placoid pigment epitheliopathy in which an ocular coherence tomographic scan was performed through an acute lesion and then repeated through the same lesion 12 months later. The initial ocular coherence tomographic scan showed marked anterior displacement of both neuroretina and outer reflective band. A subsequent ocular coherence tomographic scan revealed resolution of the prior displacement, increased reflectance of the outer reflective band and mild disruption of the outer retinal layers. These findings are consistent with a primary choroiditis.
    Clinical and Experimental Ophthalmology 10/2006; 34(8):810 - 812. DOI:10.1111/j.1442-9071.2006.01357.x · 2.35 Impact Factor
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    ABSTRACT: This program, entitled Advanced Technologies for Structural and Functional Optical Coherence Tomography, is a collaborative effort between investigators at the Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics; Dr. David Boas, Associate Professor in Radiology, Harvard Medical School at the Massachusetts General Hospital, Martinos Center for Biomedical Imaging; and Dr. Jay Duker, Director, New England Eye Center, Professor and Chair of Ophthalmology, Tufts University School of Medicine. The objective of this program is to develop and apply advanced optical coherence tomography (OCT) technologies for ultrahigh resolution and functional imaging in biomedical applications.
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