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Derniers ajouts - 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 epitheliopathyvu 239 fois11 Février 2024	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 727 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 537 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 519 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 537 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 585 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 584 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 532 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 534 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 555 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 537 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 579 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 558 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 541 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 630 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 597 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 599 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 4 years after onsetvu 685 fois4 years after presentation - vision 20/80 OD 20/16 OS and there is subretinal fibrosis07 Mars 2016	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Sequential color photos show progressionvu 962 foisVision in right eye dropped to 5/200 by the last photo.03 Octobre 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Sequential color photos show progressionvu 1126 foisVision in right eye dropped to 5/200 by the last photo.03 Octobre 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - SD-OCT vu 1486 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - SD-OCT vu 1372 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - SD-OCT vu 1388 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - SD-OCT vu 921 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 811 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 736 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 835 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 780 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 718 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 905 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 683 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 923 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 694 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 754 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 734 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Indocyanine Green Angiogramvu 863 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 892 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 825 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 673 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 716 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 856 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 900 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 800 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 964 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 793 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 782 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 733 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 864 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 899 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 880 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogramvu 1132 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Red Freevu 849 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Red Free Photovu 914 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Autofluorescencevu 1225 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Autofluorescencevu 1030 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Autofluorescencevu 1004 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Autofluorescencevu 1107 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - InfraRed Photovu 848 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - InfraRed Photovu 793 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - InfraRed Photovu 842 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - InfraRed Photovu 801 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Colorvu 733 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Colorvu 996 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Colorvu 1062 fois 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 20/3228 Août 2012
Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Colorvu 1288 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Colorvu 950 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Colorvu 1154 fois 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 20/3228 Août 2012	Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Colorvu 1679 fois 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 20/3228 Août 2012
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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.