Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE
|
|
25-year-old man was seen in the office on August 24, 2012. Starting about one and half weeks ago he woke up with night chills. He had a cold. He never took his temperature. He is not sure whether he had a fever. Also around that time his joints started hurting him, specifically his elbows, knees and ankles. He also has headaches, although the headache at this point is not severe, it is actually a little less than his usual headache and does not appear to be escalating. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision. They are a little bit off to the side.
VISUAL ACUITY: OD 20/32, OS 20/32. IOP: 16 OU.
SLIT EXAMINATION: There is 1+ cell and flare of the anterior chamber in both eyes with clear lenses. There are no iris nodules.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is no posterior vitreous separation and 1+ vitreous cells. There are some splotchy white geographic areas in the posterior pole.
OS: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. There are 1+ vitreous cells. Again, there are splotchy white geographic areas in the posterior pole. In neither eye do the white spots involve the center of the macula.
FUNDUS PHOTOGRAPHY - AUTO FLUORESCENCE: The image in the left eye shows patches of hyper auto fluorescence corresponding to the areas of involvement.
FUNDUS PHOTOGRAPHY - INFRA RED: The image shows very little change, it is nearly normal.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows as you would expect, early hypofluorescence corresponding to the lesions and they are more visible on the fluorescein angiogram than they are funduscopically. In the later frames the lesions stain fairly uniformly throughout the center of them and there is even a little bit of leakage possibly associated with them. The left eye similarly shows early blocking and late staining.
INDOCYANINE GREEN ANGIOGRAPHY: The indocyanine green angiogram, which was shot out to fifteen minutes shows dense geographic blocking of the indocyanine green in the geographic areas. There are many more spots visible on indocyanine green angiogram than there are either on funduscopic or on fluorescein angiogram.
SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye shows the lesions to be predominately in the deep retina. There is clear loss of the photoreceptor integrity. The pigment epithelium looks normal in the area of the lesions, but above that the photoreceptor outer segments all the way up to the external limiting membrane lose their normal architecture and in some areas where the lesions are a little bit fresher, it looks like there is loss of the entire outer segment of the photoreceptors with only preservation of the nuclei. There is no evidence of any serous retinal detachment in either eye. The left eye similarly on the OCT scan shows over the lesion again a loss of photoreceptor integrity. There does appear to be a little bit of pigment epithelial irregularity over the dense lesion inferior to the fovea. The involvement goes all the way from the outer plexiform layer out to the retinal pigment epithelium. The edges of the lesions are sharp and no evidence of any spreading around them.
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Color1646 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Color1130 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Color926 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Color1272 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Color1053 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Color976 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Color720 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - InfraRed Photo790 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - InfraRed Photo820 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - InfraRed Photo774 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - InfraRed Photo833 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Autofluorescence1084 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Autofluorescence982 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Autofluorescence1014 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Autofluorescence1205 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Red Free Photo895 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Red Free831 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram1115 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram860 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram886 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram847 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram721 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram762 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram784 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram952 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram783 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram885 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram836 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram694 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram659 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram808 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram870 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram845 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram724 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram737 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram685 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram902 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram668 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram889 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram708 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram756 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram815 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram724 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogram794 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - SD-OCT 904 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - SD-OCT 1368 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - SD-OCT 1342 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - SD-OCT 1466 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Sequential color photos show progression1104 viewsVision in right eye dropped to 5/200 by the last photo.
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Sequential color photos show progression941 viewsVision in right eye dropped to 5/200 by the last photo.
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset664 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset583 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset584 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset607 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset520 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset533 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset562 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset516 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset534 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset516 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset514 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset561 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset565 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset518 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset496 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset510 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onset712 views4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis
(0 votes)
|
|
Acute posterior multifocal placoid pigment epitheliopathy213 views
(0 votes)
|
|
|
|
25-year-old man was seen in the office on August 24, 2012. Starting about one and half weeks ago he woke up with night chills. He had a cold. He never took his temperature. He is not sure whether he had a fever. Also around that time his joints started hurting him, specifically his elbows, knees and ankles. He also has headaches, although the headache at this point is not severe, it is actually a little less than his usual headache and does not appear to be escalating. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision. They are a little bit off to the side.
VISUAL ACUITY: OD 20/32, OS 20/32. IOP: 16 OU.
SLIT EXAMINATION: There is 1+ cell and flare of the anterior chamber in both eyes with clear lenses. There are no iris nodules.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is no posterior vitreous separation and 1+ vitreous cells. There are some splotchy white geographic areas in the posterior pole.
OS: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. There are 1+ vitreous cells. Again, there are splotchy white geographic areas in the posterior pole. In neither eye do the white spots involve the center of the macula.
FUNDUS PHOTOGRAPHY - AUTO FLUORESCENCE: The image in the left eye shows patches of hyper auto fluorescence corresponding to the areas of involvement.
FUNDUS PHOTOGRAPHY - INFRA RED: The image shows very little change, it is nearly normal.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows as you would expect, early hypofluorescence corresponding to the lesions and they are more visible on the fluorescein angiogram than they are funduscopically. In the later frames the lesions stain fairly uniformly throughout the center of them and there is even a little bit of leakage possibly associated with them. The left eye similarly shows early blocking and late staining.
INDOCYANINE GREEN ANGIOGRAPHY: The indocyanine green angiogram, which was shot out to fifteen minutes shows dense geographic blocking of the indocyanine green in the geographic areas. There are many more spots visible on indocyanine green angiogram than there are either on funduscopic or on fluorescein angiogram.
SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye shows the lesions to be predominately in the deep retina. There is clear loss of the photoreceptor integrity. The pigment epithelium looks normal in the area of the lesions, but above that the photoreceptor outer segments all the way up to the external limiting membrane lose their normal architecture and in some areas where the lesions are a little bit fresher, it looks like there is loss of the entire outer segment of the photoreceptors with only preservation of the nuclei. There is no evidence of any serous retinal detachment in either eye. The left eye similarly on the OCT scan shows over the lesion again a loss of photoreceptor integrity. There does appear to be a little bit of pigment epithelial irregularity over the dense lesion inferior to the fovea. The involvement goes all the way from the outer plexiform layer out to the retinal pigment epithelium. The edges of the lesions are sharp and no evidence of any spreading around them.
