Acute Posterior Multifocal Placoid Pigment Epitheliopathy versus Vogt-Koyanagi-Harada Disease: Tomographic Characteristics

Nakhleh E. Abu-Yaghi, Ahmed N. Shokry


Objective: To report a case of a male patient with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) mimicking acute Vogt-Koyanagi-Harada (VKH) disease, discuss imaging findings and review pertinent tomography literature contributing to this diagnostic challenge.

Case Report: A twenty six year-old male presented with bilateral blurring of vision for 2 weeks, for which he underwent full ophthalmologic examination, laboratory evaluation, B-scan ultrasonography, fluorescein angiography and spectral domain optical coherence tomography (OCT). OCT disclosed multifocal intra-retinal lobulated cystic fluid collections with septae of variable thickness, disruption of the photoreceptor layer with choroidal thickening and hyper-reflectance in outer retinal layers.

Conclusions: APMPPE and acute VKH can present with substantial overlap in symptoms, signs and ophthalmic imaging characteristics. OCT offers valuable information about both shared and different features. A holistic approach is necessary to reach a proper diagnosis and plan treatment and follow up.


Acute posterior multifocal placoid pigment epitheliopathy; Vogt-Koyanagi-Harada disease; Fluorescein angiography; Optical coherence tomography

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