Maurice F. Rabb » Acute Multifocal Placoid Pigment Epitheliopathy (AMPPE)

This 25 year old white male law student was seen on 4/29/93 and one week previously had fever, felt woozy, and had a headache. This lalsted a week. Has a two-day history of reduced vision, more so in the right eye than the left eye. Vision on 4/29/93 RE: 20/200; LE: 20/250. Had typical AMPPE. Fluorescein angiogram was done and the patient was followed.

The patient returned on 5/7/93. Vision OU: 20/250. Lesions were beginning to pigment. At this point, ICG was done. The patient has been followed.

The patient was last seen 8/13/93. Vision RE: 20/25; LE: 20/80. The lesions were well-pigmented.

The reason I am presenting this case is because of the remarkable ICG findings. Note the tremendous hypofluorescence of the posterior pole of each eye. Is this pigment epithelial edema blocking choroidal fluorescence, or is this marked ischemia of the small vessels (including choriocapillaris) of the choroid?

I have seen two other cases of AMPPE in the acute phase, each of which show this same finding.