Acute posterior multifocal placoid pigment epitheliopathy: monitoring using optical coherence tomography

Abstract. This clinical case draws attention to the possibilities of studying the retina using structural and angio-OCT (optical coherence tomography) in acute posterior multifocal placoid pigment epitheliopathy. At the very beginning of the disease, according to structural ОСТ data, several cystic formations merging with each other were detected in the area of the retinal pigment epithelium in the central zone of the macula. A month later, on structural ОСТ of the right eye, foci in the RPE area remained, their caliber decreased. In the affected area, the optical permeability of the pigment epithelium increased significantly due to further damage to its structure. 2 months after the first manifestations of the disease in the right eye, persistent damage was formed in the region of the RPE. Angio-OCT studies in dynamics made it possible to indirectly monitor the formation of RPE damage. According to angio-OCT performed a year after the onset of the disease, it is obvious that RPE damage, despite the absence of a clinical picture of the disease, continues to progress during the year from the onset of the disease. Thus, the study of the retina by structural and angio-OCT makes it possible to detect initial lesions in acute posterior multifocal placoid pigment epitheliopathy. They consist in the formation of pathological foci in the RPE region, followed by the formation of zones of atrophy of the pigment epithelium. The angio-OCT method makes it possible to indirectly judge the extent of areas of RPE disorganization, as well as to track the dynamics of these changes.