Long-term follow-up of acute multifocal posterior placoid pigment epitheliopathy

SUMMARY Eleven patients with acute multifocal posterior placoid pigment epitheliopathy were followed up for 47 to 175 months (mean 106 months). Seven of 18 affected eyes (39%) developed progressive mild alterations in the retinal pigment epithelium. Seventeen eyes (94%) had a final visual acuity of 20/30 or better. One eye with progressive retinal pigment atrophy involving the fovea lost visual acuity from 20/25 to 20/60. Acute multifocal posterior placoid pigment epithelio-pathy (AMPPPE) was first described by Gass in 1968. ' Since then there have been many reports describing its appearance, associated manifestations, course and prognosis.'- " But there have been few long-term follow-up studies performed. 'I ' While these have primarily emphasised the long-term visual outcome, one study reported the development of widespread chorioretinal atrophy and associated visual loss in several patients.2' The purpose of this report is to provide a long-term follow-up of patients with AMPPPE, with special emphasis on the development of any progressive fundus changes and the effect of such changes on visual outcome. Patients and methods Patients with a diagnosis of AMPPPE were identified from the clinic and photography records of the retina service at the Eye Institute of the Medical College of Wisconsin. The patient's history and details of the initial ophthalmic examination were reviewed. Fundus photographs and the fluorescein angiogram were reviewed to confirm the clinical diagnosis of AMPPPE. Diagnostic criteria included the presence of multifocal placoid lesions affecting the retinal pigment epithelium or choroid that blocked chor