Título / Title

ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY

Introdução / Purpose

The condition was first described by Donald Gass (1968), who detected multiple spot-like lesions at the level of the pigment epithelium in the acute phase, with spontaneous resolution and culminating in slight scarring. The disease, which affects healthy young men and women, between the ages of 20 and 30, is associated with a viral prodrome. Affected patients report loss of central and paracentral vision, scotomas and photopsias. Fundoscopic lesions are placoid, cream-colored, multifocal, of variable size,. In more severe cases cystoid macular edema and optic disk edema may occur. At fluorescein angiography recent lesions are hypofluorescent in the initial phases and culminate in staining in the late phase.

Material e Método / Methods

Report of 2 cases in young patients who presented regression after systemic corticotherapy, since the optic nerve was involved.
Exams: simple retinography, standard angiogram and fluorescein angiography.

Resultados / Results

JMQ, 12 years old, revealed flat, yellowish-white pigment epithelium, multifocal, placoid lesions of varying size on the posterior pole and midperiphery. The left eye also showed areas of sensory detachment. After dye injection, small areas of hypofluorescence appeared bilaterally in the initial phases of the examination, progressively permeated by the dye, which tends to coalesce, forming an accumulation in the sub-retinal space of the left eye. RMS, female, 39 years old. Standard angiogram of both eyes revealed isolated yellowish-white multifocal placoid lesions (a few confluent), surrounded by hypopigmented halos of varying size, located from the posterior pole to the equator.

Discussão e Conclusões / Conclusion

We conclude the diagnosis of choroidoretinal pathologies should be increasingly improved, by means of sophisticated laboratory or imaging examinations. As long as they are precise, we will be able to treat only cases that are not self-limiting and need prompt intervention to prevent definitive visual impairment, given that the disease is bilateral.

Palavras Chave

EPITHELIOPATHY - PLACOID - MULTIFOCAL