University of Iowa Health Care

Ophthalmology and Visual Sciences

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Acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

Contributor: Angela McAllister, MD

Photographer: Brice Critser, CRA

APMPPE is one of the white dot syndromes that occurs in young healthy adults and similarly affects males and females. It is usually bilateral, although may be worse in one eye. APMPPE is generally a self-limited condition that requires no treatment and has a good prognosis.


A 47-year-old female presents with a four day history of fluttering bright spots in the right eye. She denies a viral prodrome or headaches.

Figure 1: Color fundus photo, right eye (OD): Multiple creamy yellow-white lesions throughout the macula. There is mild vitritis on exam and mild disc edema.

Fundus photo. multiple creamy yellow-white lesions whtoughout the maculs

Figure 2: Optical coherence tomography OD: Disruption of the outer retinal layers.

Optical coherence tomography OD: Disruption of the outer retinal layers

Figure 3: Laminar phase of fluorescein angiogram demonstrating early hypofluorescence of the lesions

Laminar phase of fluorescein angiogram demonstrating early hypofluorescence of the lesions

Figure 4: Late phase of fluorescein angiogram demonstrating late staining of lesions


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last updated: 04/14/2014