RESUMO
PURPOSE: To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) with exudative retinal detachment, simulating acute Vogt-Koyanagi-Harada (VKH) disease and to review relevant imaging literature. METHODS: Ophthalmologic examination, laboratory evaluation, fluorescein angiography, and B-scan ultrasonography performed at baseline, as well as spectral domain optical coherence tomography (OCT) and fundus autofluorescence performed upon initial presentation and at 5-day, 1-month, and 3-month follow-up. RESULTS: OCT demonstrated outer retinal hyperreflectance and subretinal fluid in the acute phase that disappeared 5 days later. Choroidal thickening was noted on OCT and ultrasonography. Retinal pigment epithelium lesions were hypoautofluorescent acutely but became hyperautofluorescent later in the disease course. CONCLUSIONS: At presentation, there can be considerable overlap in both clinical and imaging findings in APMPPE mimicking acute VKH, making it difficult to differentiate these two entities. Cerebral spinal fluid analysis and follow-up examinations could help in arriving at proper diagnosis.
Assuntos
Doenças Retinianas/diagnóstico , Tomografia de Coerência Óptica/métodos , Síndrome Uveomeningoencefálica/diagnóstico , Doença Aguda , Anti-Inflamatórios/uso terapêutico , Angiofluoresceinografia , Fluorescência , Fundo de Olho , Humanos , Masculino , Epitélio Pigmentado Ocular/patologia , Prednisona/uso terapêutico , Doenças Retinianas/tratamento farmacológico , Líquido Sub-Retiniano/efeitos dos fármacos , Resultado do Tratamento , Síndrome Uveomeningoencefálica/tratamento farmacológico , Síndrome Uveomeningoencefálica/patologia , Acuidade Visual , Adulto JovemRESUMO
PURPOSE: To identify clinical findings associated with claw-shaped patterns on corneal topography. DESIGN: Retrospective, observational case series. METHODS: Forty eyes (26 patients) with classic claw-shaped patterns on corneal topography were identified from 3,993 Orbscan II records. They were subclassified into three groups: Group 1 (pellucid marginal degeneration [PMD] or PMD suspect); group 2 (keratoconus or keratoconus suspect); and group 3 (ectasia). The refractive and topographic indices of groups 1 and 2 were compared. RESULTS: There were nine eyes (six patients) in group 1, 27 eyes (18 patients) in group 2, and four eyes (two patients) in group 3. The mean radii of maximal anterior (2.96 mm) and posterior (3.06 mm) elevation in group 1 were significantly greater than those of group 2 (1.89 mm; P = .018 and 1.72 mm; P = .022, respectively). CONCLUSIONS: The claw-shaped pattern on corneal topography is not diagnostic of PMD; it is also seen in keratoconus.
