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ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY AND PLACOID VARIANT DISEASES MASQUERADING AS AGE-RELATED MACULAR DEGENERATION IN THE ELDERLY: A Case Series.
Cheng, John Yu; Santina, Ahmad; Margines, J Ben; Voichanski, Shilo; Ramtohul, Prithvi; Bousquet, Elodie; Bijon, Jacques; Freund, K Bailey; Yannuzzi, Lawrence; Sarraf, David.
Afiliación
  • Cheng JY; Jules Stein Eye Institute, University of California Los Angeles, Los Angeles.
  • Santina A; Jules Stein Eye Institute, University of California Los Angeles, Los Angeles.
  • Margines JB; Jules Stein Eye Institute, University of California Los Angeles, Los Angeles.
  • Voichanski S; Jules Stein Eye Institute, University of California Los Angeles, Los Angeles.
  • Ramtohul P; Vitreous Retina Macula Consultants of New York, New York, New York; and.
  • Bousquet E; Jules Stein Eye Institute, University of California Los Angeles, Los Angeles.
  • Bijon J; Vitreous Retina Macula Consultants of New York, New York, New York; and.
  • Freund KB; Vitreous Retina Macula Consultants of New York, New York, New York; and.
  • Yannuzzi L; Vitreous Retina Macula Consultants of New York, New York, New York; and.
  • Sarraf D; Jules Stein Eye Institute, University of California Los Angeles, Los Angeles.
Retina ; 44(10): 1666-1678, 2024 10 01.
Article en En | MEDLINE | ID: mdl-39027974
ABSTRACT

PURPOSE:

To report eight cases of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) or persistent placoid maculopathy (PPM) initially masquerading as age-related macular degeneration in elderly individuals.

METHODS:

APMPPE or PPM eyes in patients above age 55 years with macular retinal pigment epithelium disruption including drusenoid lesions on macular examination and/or with multimodal imaging were included. At least one method of multimodal imaging including fluorescein angiography (FA), indocyanine green angiography, optical coherence tomography (OCT), and OCT angiography (OCTA) was performed in all eyes for diagnosis and to monitor for macular neovascularization.

RESULTS:

Eight elderly male patients presented with vision loss and were all initially diagnosed with non-neovascular or neovascular age-related macular degeneration. With the aid of multimodal retinal imaging, a final diagnosis of either APMPPE or PPM was rendered. With FA and indocyanine green angiography, choroidal hypoperfusion was detected in all but one eye. With OCT, the angular sign of Henle fiber layer hyperreflectivity was identified in >50% of eyes. With OCTA, inner choroidal flow deficits were detected in all eyes. Macular neovascularization requiring anti-vascular endothelial growth factor injection therapy complicated three of eight cases.

CONCLUSION:

Both APMPPE and PPM may develop in elderly individuals and may masquerade as age-related macular degeneration on presentation. Multimodal imaging including FA, indocyanine green angiography, and OCTA are important diagnostic modalities to assess for inner choroidal hypoperfusion to arrive at an accurate diagnosis and to detect macular neovascularization, which frequently complicates APMPPE and PPM. In these patients, serial anti-vascular endothelial growth factor intravitreal injections are essential in treating macular neovascularization and in preventing significant vision loss.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía con Fluoresceína / Agudeza Visual / Tomografía de Coherencia Óptica / Epitelio Pigmentado de la Retina / Imagen Multimodal Límite: Aged / Aged80 / Humans / Male / Middle aged Idioma: En Revista: Retina Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía con Fluoresceína / Agudeza Visual / Tomografía de Coherencia Óptica / Epitelio Pigmentado de la Retina / Imagen Multimodal Límite: Aged / Aged80 / Humans / Male / Middle aged Idioma: En Revista: Retina Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos