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Ophthalmology and Visual Sciences

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

Category(ies): Retina, Vitreous, Uveitis
Contributor: Angela McAllister, MD
Photographer: Brice Critser, CRA

APMPPE is one of the white dot syndromes that occurs in young healthy adults and similarly affects males and females. It is usually bilateral, although may be worse in one eye. APMPPE is generally a self-limited condition that requires no treatment and has a good prognosis.

A 47-year-old female presents with a four day history of fluttering bright spots in the right eye. She denies a viral prodrome or headaches.

fundus image, yellow-white lesions throughout the macula
Color fundus photo, right eye (OD): Multiple creamy yellow-white lesions throughout the macula. There is mild vitritis on exam and mild disc edema.
OCT
Optical coherence tomography OD: Disruption of the outer retinal layers.
hypofluorescence of the lesions
Laminar phase of fluorescein angiogram demonstrating early hypofluorescence of the lesions
fluorescein angiogram demonstrating late staining of lesions
Late phase of fluorescein angiogram demonstrating late staining of lesions