Cohen Liza M, Munk Marion R, Goldstein Debra A, Jampol Lee M
*Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and †Department of Ophthalmology, Medical University Vienna, Vienna, Austria.
Retin Cases Brief Rep. 2015 Summer;9(3):226-30. doi: 10.1097/ICB.0000000000000145.
To report the case of a patient with recurrent, acute posterior multifocal placoid pigment epitheliopathy. To the best of our knowledge, this is the longest documented course with the greatest number of recurrences reported.
Observational case report of one patient. A 27-year-old otherwise healthy male patient presented with recurrence of new scotomata over 15 years. Fundus photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence, and optical coherence tomography documented his clinical course.
Over the course of 15 years, the patient developed 11 symptomatic (5 imaging-documented) recurrences of acute, posterior multifocal placoid pigment epitheliopathy affecting both eyes. Each episode manifested with new subjective scotomata and new lesions noted on imaging. Symptoms mostly resolved after each episode, and visual outcome remained excellent (20/20 in the right eye and 20/25 left eye at the last follow-up).
Although typically monophasic, acute posterior multifocal placoid pigment epitheliopathy can rarely present with a recurrent course over a prolonged period of time and should be considered as a diagnosis in patients presenting with recurrent visual symptoms and new placoid lesions on imaging. In recurrent cases, visual recovery may still remain excellent.
报告一例复发性急性后极部多灶性鳞状色素上皮病变患者。据我们所知，这是有记录以来病程最长且复发次数最多的病例。
对一名患者的观察性病例报告。一名27岁身体健康的男性患者在15年期间出现新的暗点复发。眼底照相、荧光素血管造影、吲哚菁绿血管造影、眼底自发荧光和光学相干断层扫描记录了他的临床病程。
在15年的病程中，该患者双眼出现了11次有症状的（5次有影像学记录）急性后极部多灶性鳞状色素上皮病变复发。每次发作均伴有新的主观暗点和影像学上发现的新病变。每次发作后症状大多缓解，末次随访时视力预后仍极佳（右眼20/20，左眼20/25）。
尽管急性后极部多灶性鳞状色素上皮病变通常为单相病程，但极少数情况下可在较长时间内呈复发性病程，对于出现复发性视觉症状且影像学上有新的鳞状病变的患者应考虑该诊断。在复发病例中，视力恢复仍可能极佳。
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