Acute posterior multifocal placoid pigment epitheliopathy: a long-term study.
To study the long-term visual outcome in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Fifteen patients (28 eyes) with APMPPE were reassessed at Westmead Hospital Eye Clinic (Westmead, NSW, Australia) up to 18 years (mean 6.4 years) after their initial presentation to one of the authors (PM) or to their private ophthalmologist. Stereo retinal photographs and visual acuities taken at the initial presentation were compared with those obtained at the most recent follow-up visit. The last recorded visual acuity was 6/6 or better in 16 eyes (57%), 6/9-6/18 in four eyes (14%), 6/24-6/60 in five eyes (18%) and worse than 6/60 in three eyes (11%). Nine patients (60%) were treated with oral prednisone during the acute episode with little therapeutic effect observed. Six patients (40%) described a prodromal flu-like illness. This study suggests that the long-term visual outcome following an acute episode of APMPPE may not be as favourable as initially portrayed by Gass. It confirms other study findings suggesting that APMPPE may not be a benign self-limiting disease. Older age at onset and initial foveal involvement were associated with a worse visual outcome.