Atypical Acute Posterior Multifocal Placoid Pigment Epitheliopathy.

PURPOSE: To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) with atypical features.

CASE REPORT: A 30-year-old otherwise healthy woman presented with a 7-day history of visual disturbance in her left eye. The best corrected visual acuity in her left eye was 6/36. Funduscopy revealed multiple cream-colored placoid lesions, serous macular elevation, and papillitis. Fundus fluorescein angiography revealed early hypofluorescence and late hyperfluorescence. Systemic and neurologic assessments were normal. The case shared features with both APMPPE and Harada's disease, making it a diagnostic challenge. However, APMPPE may rarely mimic Harada's disease when it manifests with atypical features, like serous retinal detachment and papillitis. The patient was managed with oral prednisolone with slow tapering. Her visual acuity improved gradually to 6/12. Neither involvement of fellow eye nor recurrence in same eye was noted for a period of 1 year.

CONCLUSIONS: Acute posterior multifocal placoid pigment epitheliopathy may rarely manifest with atypical features, including papillitis and serous retinal detachment, perplexing the diagnosis and management.