Posterior & Placoid - FFA & Other investigations
𝗔𝗣𝗠𝗣𝗣𝗘 - 𝘐𝘯𝘷𝘦𝘴𝘵𝘪𝘨𝘢𝘵𝘪𝘰𝘯𝘴
● 𝗙𝗹𝘂𝗼𝗿𝗲𝘀𝗰𝗲𝗶𝗻 𝗔𝗻𝗴𝗶𝗼𝗴𝗿𝗮𝗺 (𝗙𝗔): 𝗘𝗮𝗿𝗹𝘆 𝗵𝘆𝗽𝗼𝗳𝗹𝘂𝗼𝗿𝗲𝘀𝗰𝗲𝗻𝗰𝗲 (𝗯𝗹𝗼𝗰𝗸𝗮𝗴𝗲) 𝗰𝗼𝗿𝗿𝗲𝘀𝗽𝗼𝗻𝗱𝗶𝗻𝗴 𝘁𝗼 𝘁𝗵𝗲 𝗽𝗹𝗮𝗰𝗼𝗶𝗱 𝗹𝗲𝘀𝗶𝗼𝗻𝘀 𝗳𝗼𝗹𝗹𝗼𝘄𝗲𝗱 𝗯𝘆 𝗹𝗮𝘁𝗲, 𝗶𝗿𝗿𝗲𝗴𝘂𝗹𝗮𝗿 𝗵𝘆𝗽𝗲𝗿𝗳𝗹𝘂𝗼𝗿𝗲𝗰𝗲𝗻𝘁 𝘀𝘁𝗮𝗶𝗻𝗶𝗻𝗴
● 𝘐𝘯𝘥𝘰𝘤𝘺𝘢𝘯𝘪𝘯𝘦 𝘎𝘳𝘦𝘦𝘯 (𝘐𝘊𝘎) 𝘈𝘯𝘨𝘪𝘰𝘨𝘳𝘢𝘮: Early and late hypofluorescence corresponding to the placoid lesions
● 𝘍𝘶𝘯𝘥𝘶𝘴 𝘢𝘶𝘵𝘰𝘧𝘭𝘰𝘶𝘳𝘦𝘴𝘤𝘦𝘯𝘴𝘦 (𝘍𝘈𝘍): Early and late hypoautoflourescence corresponding to the placoid lesions. Hypoautoflourescence may persist at borders after lesion resolution
● 𝘖𝘱𝘵𝘪𝘤𝘢𝘭 𝘤𝘰𝘩𝘦𝘳𝘦𝘯𝘤𝘦 𝘵𝘰𝘮𝘰𝘨𝘳𝘢𝘱𝘩𝘺 (𝘖𝘊𝘛): Hyperreflectivity from the outer plexiform layer to the RPE with normal retinal thickness in acute lesions. Hyperreflectivity of outer layers resolve along with resolution of the lesion.
In some cases, subretinal fluid can be seen.
● CNS imaging should be performed to rule out CNS vasculitis in all patients with a new diagnosis of APMPPE.
𝘗𝘳𝘰𝘨𝘯𝘰𝘴𝘪𝘴 𝘢𝘯𝘥 𝘔𝘢𝘯𝘢𝘨𝘦𝘮𝘦𝘯𝘵
● Usually self-limiting with good prognosis
● Risk factors for visual loss - foveal involvement at presentation, older age, unilateral disease, longer interval between initial and fellow eye involvement, recurrences
● All patients with a new diagnosis of APMPPE should receive a full neurologic and systemic work-up to evaluate for CNS vasculitis and other associated systemic conditions
● Role of steroids not fully understood
www.ophthalmobytes.com
Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #retina #apmppe #whitedotsyndrome #placoid #macula #posteriorpole
