Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) Treatment & Management

Updated: Jul 22, 2019
  • Author: Lakshmana M Kooragayala, MD; Chief Editor: C Stephen Foster, MD, FACS, FACR, FAAO, FARVO  more...
  • Print
Treatment

Approach Considerations

Conservative management is recommended; treat ocular complications or systemic vasculitis as indicated.

Next:

Medical Care

The treatment of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is controversial. The fundus lesions appear to run a relatively self-limited course with no treatment. Systemic steroids or biologic agents such as tumor necrosis factor inhibitors (eg, infliximab) may be considered in cases involving significant visual problems, recurrent debilitating cases, or cases involving systemic problems. [20, 4]

Previous
Next:

Surgical Care

In cases complicated by choroidal neovascularization, laser photocoagulation and intravitreal injection of antivascular growth factors (eg, bevacizumab, ranibizumab, aflibercept [off-label use]) can be considered. [20]

Previous
Next:

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

Previous
Next:

Diet

No dietary restrictions are indicated.

Previous
Next:

Activity

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

Previous
Next:

Further Outpatient Care

Monitor the clinical course of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) every 1-2 weeks and for onset of systemic complications.

Previous