Case 1

Contributors: Dr. John Liu, Dr. Irfan Kherani, Dr. Chloe Gottlieb

Patient Presentation: A 31-year-old female presents with a 1-week history of sudden, painless, bilateral blurred vision with central scotomas, worse in her right eye. Two weeks prior, she experienced flu-like symptoms, which have now resolved. On fundus exam, there are creamy grey-white placoid lesions at the level of the retinal pigment epithelium (RPE) in the posterior pole.

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Question: The patient's OCT is shown above. What abnormalities do you visualize in the patient's OCT image?

Question: What is the diagnosis?

Question: If this is her first presentation, what other systemic conditions should this patient be worked up for?

Learning Objectives:

1. Identify OCT features of acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

2. Recognize associations of APMPPE with other systemic conditions