Acute Posterior Multifocal Placoid Pigmentepitheliopathy (APMPPE) - a Rare Cause of an Uveitis Posterior
Hoffmann S., Bartram M., Wiedemann P., Kohen L.
Purpose: The acute posterior multifocal placoid pigmentepitheliopathy is an uncommon, idiopathic, selflimiting, bilateral cause of a posterior uveitis affecting young healthy adults. APMPPE is associated with the expression of HLA-DR2 and HLA-DR27.
Results: We report the case of a 42 year old female patient with diminished vision of both eyes and eye redness. The ophthalmologic examination disclosed flare in the anterior chamber. The inflammation was stronger in the left eye. The funduscopic examination revealed no abnormality. The patient was treated with prednisolonacetate and and atropine eye drops. During the treatment, the visual acuity of the right eye diminished and funduscopic examination showed yellowish chorioretinal infiltrates. Because of chorioretinal infiltrates next to the fovea, the patient was hospitalized and a systemic steroid treatment was started. Furthermore, a search for the reason of the uveitis was started. An angiographic examination revealed hypofluorescent areas in the early phase, changing to hyperfluorescence in the late phase. No systemic illness was found. Because of the typical clinical and angiographic features, we diagnosed an APMPPE. A laboratory examination revealed the expression of HLA-DR2 in our patient. In addition, we excluded a vasculitis which is sometimes associated with APMPPE.
Conclusions: APMPPE has to be considered as
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