Beketova Tatyana R, Snyder Kiersten, Jiang Alicia, Josephberg Robert G
Ophthalmology, New York Medical College, Valhalla, USA.
Cureus. 2023 Feb 26;15(2):e35499. doi: 10.7759/cureus.35499. eCollection 2023 Feb.
The purpose of this study was to report the rare presentation of bilateral acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and unilateral papillitis treated successfully with corticosteroid therapy. The methods used in this study include fundus photography and fluorescein angiography. A 40-year-old female presented to the emergency room with decreased vision, headache, and photophobia with fundus examination findings of bilateral creamy placoid lesions in the posterior pole and unilateral papillitis, macular edema, and disc hemorrhages. Fluorescein angiography demonstrated early hypofluorescence corresponding to the placoid lesions followed by late, irregular hyperfluorescent staining. Optical coherence tomography revealed peripapillary and macular edema of the left eye. The patient was treated with two retrobulbar corticosteroid injections and a course of oral prednisone with improvement in fundus findings and visual acuity at follow-up examination six weeks from the presentation. The presence of optic nerve and macular edema in APMPPE suggests severe chorioretinal inflammation for which systemic and local corticosteroids are a reasonable treatment option.
本研究的目的是报告双侧急性后极部多灶性扁平状色素上皮病变（APMPPE）和单侧视乳头炎的罕见表现，其通过皮质类固醇治疗成功治愈。本研究中使用的方法包括眼底照相和荧光素血管造影。一名40岁女性因视力下降、头痛和畏光就诊于急诊室，眼底检查发现双侧后极部有奶油色扁平状病变以及单侧视乳头炎、黄斑水肿和视盘出血。荧光素血管造影显示早期与扁平状病变对应的低荧光，随后是晚期不规则高荧光染色。光学相干断层扫描显示左眼视乳头周围和黄斑水肿。患者接受了两次球后皮质类固醇注射和一个疗程的口服泼尼松治疗，在就诊六周后的随访检查中，眼底表现和视力有所改善。APMPPE中视神经和黄斑水肿的存在提示严重的脉络膜视网膜炎症，全身和局部使用皮质类固醇是一种合理的治疗选择。
