Título

ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY

Introdução / Purpose

The condition was first described by Donald Gass (1968), who detected multiple spot-like lesions at the level of the pigment epithelium, with spontaneous resolution and culminating in slight scarring. The disease is associated with a viral prodrome. Fundoscopic lesions are placoid, cream-colored, multifocal, of variable size, located at the posterior pole. In more severe cases cystoid macular edema and optic disk edema may occur. At fluorescein angiography, recent lesions are hypofluorescent in the initial phases of the examination, and culminate in staining in the late phase.

Material e Método / Methods

Report of 2 cases of APMPPE, young patients who presented regression after systemic corticotherapy, since the optic nerve was involved. Simple retinography and standard angiogram of both eyes of JMQ, 12 years old, revealed flat, yellowish-white pigment epithelium, multifocal, placoid lesions of varying size on the posterior pole and midperiphery. RMS, female, 39 years old. Standard angiogram of both eyes revealed isolated yellowish-white multifocal placoid lesions (a few confluent).

Resultados / Results

During the examination she exhibited centrifugal hyperfluorescence of the lesions with diffusion in the late phase. Hot spots can be seen in both eyes. In the right eye there is an area of serous detachment of the pigment epithelium inferior to the macula and pooling of dye in the region of sensory detachment in the area of the superior temporal vascular arcades. In the late phase we also observed exacerbation of papillary staining in both eyes, causing inaccurate fluorescence at the edges of the left optic disk. There was an extended choroidal filling phase.

Discussão e Conclusões / Discussion

We conclude the diagnosis of choroidoretinal pathologies should be increasingly improved, by means of sophisticated laboratory or imaging examinations. As long as they are precise, we will be able to treat only cases that are not self-limiting and need prompt intervention to prevent definitive visual impairment, given that the disease is bilateral.

Palavras Chave

EPITHELIOPATHY, PLACOID, MULTIFOCAL.