Abstract
A previously healthy patient presented to a tertiary eye care center reporting several days of bilateral photosensitivity and eye redness in the setting of one week of fevers, chills, fatigue, and diffuse adenopathy. Initial exam was only notable for mild anterior chamber reaction, but a repeat exam in the days that followed demonstrated new sub-retinal lesions in both eyes. Multimodal imaging was employed. OCT demonstrated focal hyperreflectivity of the outer retina. FA demonstrated multifocal areas of late leakage. ICG demonstrates numerous hypocyanescent lesions. The patient was observed closely and improved both subjectively and on imaging. The collection of imaging findings, along with the presentation and rapid resolution was most consistent with acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Multimodal imaging is key in the differentiation of inflammatory chorioretinopathies. Central nervous system involvement is rare but must be considered. In certain cases, observation without the use of steroids is an appropriate treatment option.
Presentation Date: 07/31/2025
Issue Date: 02/13/2026
