Acute Multifocal Placoid Pigment Epitheliopathy Treatment & Management

  • Author: Lakshmana M Kooragayala, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Aug 4, 2011
 

Medical Care

The treatment of APMPPE is somewhat controversial; however, the consensus is that no treatment seems to alter the course of the ocular lesions. The fundus lesions appear to run a relatively short self-limited course, which probably results from a one-time insult to the capillaries comprising the choroidal lobules.

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Surgical Care

In cases complicated by subretinal neovascularization, laser photocoagulation may be useful.

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Consultations

Consultations may be indicated if the diagnosis is not clear or if a systemic manifestation indicates such a need (an infrequent occurrence).

  • Neurologist/neurosurgeon - CNS symptoms
  • Urologist - Urinalysis findings
  • Dermatologist - Skin findings
  • Rheumatologist - Serum immunologic abnormalities
  • Infectious disease specialist
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Diet

No dietary restrictions are indicated.

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Activity

No limitations of visual or physical activities are indicated unless systemic manifestations impose limitation of physical activities.

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Contributor Information and Disclosures
Author

Lakshmana M Kooragayala, MD  Vitreo-retinal Surgeon, Marietta Eye Clinic

Lakshmana M Kooragayala, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, and Medical Association of Georgia

Disclosure: Nothing to disclose.

Specialty Editor Board

Andrew A Dahl, MD  Director of Ophthalmology Teaching, Mid-Hudson Family Practice Institute, The Institute for Family Health; Assistant Professor of Surgery (Ophthalmology), New York College of Medicine

Andrew A Dahl, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

R Christopher Walton, MD  Professor, Director of Uveitis and Ocular Inflammatory Disease Service, Department of Ophthalmology, Assistant Dean for Graduate Medical Education, University of Tennessee College of Medicine; Consulting Staff, Regional Medical Center, Memphis Veterans Affairs Medical Center, St Jude Children's Research Hospital

R Christopher Walton, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Healthcare Executives, American Uveitis Society, Association for Research in Vision and Ophthalmology, and Retina Society

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous coauthor, James P Ganley, MD, PharmD, DrPH, to the development and writing of this article.

References

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Posterior pole of right eye. Early acute posterior multifocal placoid pigment epitheliopathy lesion shows yellowish-white placoid lesion involving the macula and an area just inferior temporal to the macula.
Fluorescein angiography showing peripheral hypofluorescence and central leakage of the lesion inferior temporal to the macula.
Posterior pole of left eye of same patient showing acute posterior pole placoid lesion.
Fluorescein angiogram of the patient above in late phase showing late staining of placoid areas.
Inferior nasal of right eye of the same patient approximately 2 months later, showing scattered areas of retinal pigment epithelium atrophy and hyperplasia.
Fluorescein angiography of same patient in late phase showing areas of late staining.
This image shows localized scleritis superiorly.
 
 
 
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