Papillitis in acute posterior multifocal placoid pigment epitheliopathy under oral steroid treatment

Abstract

A 54-year-old woman presented with complaints of worsening vision in left eye. Funduscopic examination showed yellowish creamy placoid like lesions superotemporal to the optic nerve in the left eye with no evidence of disk edema and vitritis. She was diagnosed with APMPPE and after ruling out infectious causes started on a 1 mg/kg/day oral prednisone. 1 month later, she presented to with an acute worsening of vision in left eye. Her visual acuity was hand motion in the left eye. Funduscopy showed marked inflammatory lesions and papillitis in the left eye. OCT showed subretinal fluid and PED in the left eye. Oral prednisone was tapered gradually under close follow-up. 3 months later her visual acuity increased 20/200 and papillitis was relieved. This is the first reported case of APMPPE that evolving papillitis under treatment, and after cessation of treatment, improved.