Different clinical presentations of persistent placoid maculopathy: a case series.

BACKGROUND

Persistent placoid maculopathy is a rare clinical entity defined as idiopathic bilateral chorioretinopathy. We report four different clinical presentations of this pathology.

CASE PRESENTATION

Case 1: A 63-year-old man presented with a persistent bilateral central scotoma. Persistent placoid maculopathy was diagnosed based on ophthalmological manifestations and multimodal imaging. A history of scalp tenderness and jaw claudication a week before visual symptoms was reported associated with increased C-reactive protein. A temporal artery biopsy confirmed the diagnosis of giant cell arteritis. Despite corticosteroid treatment, complete macular chorioretinal atrophy followed. Case 2: A 65-year-old woman was referred for bilateral blurred vision for one month. Visual acuity was 20/20 in both eyes and multimodal imaging confirmed the diagnosis of persistent placoid maculopathy. The patient was lost to follow-up due to the COVID-19 pandemic and presented one year later with decreased vision in the left eye of 20/200. Type 2 choroidal neovascularization was observed and treated with sub-tenon triamcinolone injection followed by intravitreal injection of Aflibercept allowing an improvement in visual acuity. Case 3: A 61-year-old man presented with sudden loss of vision in his right eye. A large submacular hemorrhage was observed on the right eye and hypopigmented white/yellowish plaque-like macular lesions on the other eye. Surgery with pneumatic displacement and intravitreal injection of Aflibercept was performed. No improvement in visual acuity was observed. Five months later, the contralateral eye was complicated by choroidal neovascularization and required intravitreal injections. Case 4: A 49-year-old man receiving immunosuppressive therapy after liver transplant was referred for bilateral decreased vision. The diagnosis of persistent placoid maculopathy was made, and corticosteroid treatment was initiated. After three months, chorioretinal lesions decreased and vision recovered.

CONCLUSIONS

We report the first case series of clinical presentations of persistent placoid maculopathy, which expand upon the reported ocular manifestations of this condition.