Pagliarini S, Piguet B, Ffytche T J, Bird A C
Institute of Ophthalmology, Moorfields Eye Hospital, London, UK.
Eye (Lond). 1995;9 ( Pt 1):42-7. doi: 10.1038/eye.1995.6.
Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is commonly believed to be a benign disease with excellent visual prognosis. Identification of cases with poor visual outcome prompted this retrospective study of 33 eyes of 18 patients with this disorder. Loss of visual acuity at presentation was recorded in 25 eyes (76%), 22 of which had lesions at the fovea. Visual acuity quickly returned to normal or near normal levels (even when it was as poor as counting fingers at entry) in all but 7 eyes of 7 patients, in which visual acuity failed to recover to better than 6/24 over a period of several months. All these eyes had poor acuity and foveal involvement when first seen, and at least one of the following atypical features: age older than 60 years, unilaterality, an interval before involvement of the second eye of at least 6 months, recurrence of the disease, leakage from choroidal vein. One additional patient whose foveae were initially not involved lost vision in one eye because of the development of choroidal neovascularisation. Caution should be exercised in giving a prognosis in cases when the fovea is involved and the acuity markedly reduced, particularly if one or more atypical features is present.
急性后极部多灶性鳞状色素上皮病变（APMPPE）通常被认为是一种良性疾病，视力预后良好。对视力预后不佳病例的识别促使对18例患有该疾病的33只眼进行了这项回顾性研究。25只眼（76%）在就诊时记录有视力下降，其中22只眼在黄斑中心凹有病变。除7例患者的7只眼外，所有其他眼的视力迅速恢复到正常或接近正常水平（即使在就诊时视力差至仅能数指），这7只眼在数月内视力未能恢复到优于6/24。所有这些眼在首次就诊时视力差且黄斑中心凹受累，并且至少具有以下非典型特征之一：年龄大于60岁、单眼发病、第二只眼受累前间隔至少6个月、疾病复发、脉络膜静脉渗漏。另外1例患者最初黄斑中心凹未受累，但因脉络膜新生血管形成导致一只眼失明。当黄斑中心凹受累且视力明显下降时，尤其是存在一个或多个非典型特征时，应谨慎给出预后。
