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Relentless Placoid Chorioretinitis
A New Entity or an Unusual Variant of Serpiginous Chorioretinitis?
B. Eric Jones, MD;
Lee M. Jampol, MD;
Lawrence A. Yannuzzi, MD;
Michael Tittl, MD;
Mark W. Johnson, MD;
Dennis P. Han, MD;
Janet L. Davis, MD;
David F. Williams, MD
Arch Ophthalmol. 2000;118:931-938.
Objective To characterize an unusual clinical entity resembling acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis but with an atypical clinical course.
Patients We describe 6 patients, aged 17 through 51 years, exhibiting this unusual entity who were seen at 6 different centers from 1984 to 1997.
Results The acute retinal lesions in this series were similar to those of APMPPE or serpiginous choroiditis, both clinically and on fluorescein and indocyanine green angiography. However, the clinical course, number of lesions, and location of these lesions were atypical. These patients had evidence of numerous posterior and peripheral retinal lesions predating or occurring simultaneously with macular involvement. Older, healing pigmented lesions were often accompanied by the appearance of new active white placoid lesions. Additionally, these cases all demonstrated prolonged periods of activity resulting in the appearance of more than 50 and sometimes hundreds of lesions scattered throughout the fundus. Growth of subacute lesions and the appearance of new lesions continued for 5 to 24 months after initial examination, and relapses were common.
Conclusions This entity has clinical features similar to APMPPE and serpiginous choroiditis but has a prolonged progressive clinical course and widespread distribution of lesions. It may represent a variant of serpiginous choroiditis or may be a new entity. We call it relentless placoid chorioretinitis.
From the Department of Ophthalmology, Northwestern University Medical School, Chicago, Ill (Drs Jones and Jampol); the Department of Ophthalmology, Manhattan Eye and Ear Hospital, New York, NY (Drs Yannuzzi and Tittl); the Department of Ophthalmology, University of Michigan, Kellogg Eye Center, Ann Arbor (Dr Johnson); the Department of Ophthalmology, Medical College of Wisconsin, Milwaukee (Dr Han); the Department of Ophthalmology, University of Miami School of Medicine, Miami, Fla (Dr Davis); and Vitreoretinal Surgery Physician Association, St Paul, Minn (Dr Williams). Dr Jones is currently with the Department of Ophthalmology, University of Maryland, Baltimore.
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