Kim Daniel D, Ghorayeb Ghassan
Eye Institute, West Virginia University, Morgantown, WV, USA.
Case Rep Ophthalmol Med. 2018 Sep 30;2018:1656131. doi: 10.1155/2018/1656131. eCollection 2018.
Acute posterior multifocal placoid pigment epitheliopathy (APMPEE) is a chorioretinal inflammatory disease of unknown origin. Patients usually present with a rapid loss of central/paracentral vision over the course of a week in both eyes. The fundus exhibits rapid appearance of multiple deep subretinal yellow-white, flat lesions at the RPE/choriocapillaris level. This in turn causes changes of both the ellipsoid zone and RPE which can result in permanent central vision loss. The pathogenesis is controversial but is associated with a recent viral illness and can involve the central nervous system with concern for cerebral vasculitis. Rare reports of APMPEE associated with systemic vasculitis such as Wegener's granulomatosis and malignancy such as clear cell renal carcinoma have been reported. We report a case of APMPEE with concurrent diagnosis of gastrointestinal stromal tumor and Hurthle cell tumor. While such association may well be coincidental, the near simultaneous presentation raised our suspicion for potential association.
急性后极部多灶性扁平色素上皮病变（APMPEE）是一种病因不明的脉络膜视网膜炎症性疾病。患者通常在一周内双眼迅速出现中心/旁中心视力丧失。眼底在视网膜色素上皮（RPE）/脉络膜毛细血管层迅速出现多个深层视网膜下黄白色扁平病变。这进而导致椭圆体带和RPE的改变，可导致永久性中心视力丧失。其发病机制存在争议，但与近期的病毒感染有关，并且可能累及中枢神经系统，需关注脑血管炎。已有罕见报道称APMPEE与系统性血管炎如韦格纳肉芽肿病以及恶性肿瘤如透明细胞肾癌相关。我们报告一例同时诊断为胃肠道间质瘤和许特耳细胞瘤的APMPEE病例。虽然这种关联很可能是巧合，但近乎同时出现引起了我们对潜在关联的怀疑。
