Acute posterior multifocal placoid pigment epitheliopathy associated with CN III palsy

Shani Pillar; Raz Gepstein; Orly Gal-Or; Michal Kramer

doi:10.1016/j.ajoc.2021.101102

Acute posterior multifocal placoid pigment epitheliopathy associated with CN III palsy

Shani Pillar^*, Raz Gepstein, Orly Gal-Or, Michal Kramer

^*Corresponding author for this work

Ophthalmology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Purpose: To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) associated with cranial nerve (CN) III palsy. Observations: A 20-year-old woman developed bilateral anterior uveitis, which resolved with topical steroids. Three weeks later she exhibited posterior pole lesions in both eyes, corresponding with a diagnosis of APMPPE, as confirmed by multimodal imaging. Two days later the patient presented with right CN III palsy. The patient was started on oral prednisone, which was gradually tapered off. Signs and symptoms improved rapidly, with complete resolution within two months. Conclusion and importance: Though rare, APMPPE may present with neurological involvement, as in this previously unreported association with CN III palsy. Unlike uncomplicated APMPPE cases, in patients with neurological manifestations systemic therapy is advocated.

Original language	English
Article number	101102
Journal	American Journal of Ophthalmology Case Reports
Volume	22
DOIs	https://doi.org/10.1016/j.ajoc.2021.101102
State	Published - Jun 2021

Keywords

AMPPE
APMPPE
Complication
Cranial nerve palsy
Neurological
Uveitis

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10.1016/j.ajoc.2021.101102

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title = "Acute posterior multifocal placoid pigment epitheliopathy associated with CN III palsy",

abstract = "Purpose: To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) associated with cranial nerve (CN) III palsy. Observations: A 20-year-old woman developed bilateral anterior uveitis, which resolved with topical steroids. Three weeks later she exhibited posterior pole lesions in both eyes, corresponding with a diagnosis of APMPPE, as confirmed by multimodal imaging. Two days later the patient presented with right CN III palsy. The patient was started on oral prednisone, which was gradually tapered off. Signs and symptoms improved rapidly, with complete resolution within two months. Conclusion and importance: Though rare, APMPPE may present with neurological involvement, as in this previously unreported association with CN III palsy. Unlike uncomplicated APMPPE cases, in patients with neurological manifestations systemic therapy is advocated.",

keywords = "AMPPE, APMPPE, Complication, Cranial nerve palsy, Neurological, Uveitis",

author = "Shani Pillar and Raz Gepstein and Orly Gal-Or and Michal Kramer",

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AU - Gepstein, Raz

AU - Gal-Or, Orly

AU - Kramer, Michal

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AB - Purpose: To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) associated with cranial nerve (CN) III palsy. Observations: A 20-year-old woman developed bilateral anterior uveitis, which resolved with topical steroids. Three weeks later she exhibited posterior pole lesions in both eyes, corresponding with a diagnosis of APMPPE, as confirmed by multimodal imaging. Two days later the patient presented with right CN III palsy. The patient was started on oral prednisone, which was gradually tapered off. Signs and symptoms improved rapidly, with complete resolution within two months. Conclusion and importance: Though rare, APMPPE may present with neurological involvement, as in this previously unreported association with CN III palsy. Unlike uncomplicated APMPPE cases, in patients with neurological manifestations systemic therapy is advocated.

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Acute posterior multifocal placoid pigment epitheliopathy associated with CN III palsy

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