Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an inflammatory disorder affecting the retina, retinal pigment epithelium (RPE), and choroid It is more likely to affect healthy patients of 20-40-years of age after a systemic infection.

The exact pathological origin of APMPPE remains unknown, but is believed to be a hypersensitivity-induced vasculitis and represents a primary obstruction of the choroidal circulation with secondary RPE degeneration

General symptoms include metamorphopsia, photopsia, scotomas, and blurred vision.

Fundus examination reveals multiple yellow-white placoid subretinal lesions of the posterior pole, usually bilateral and asymmetric. Fluorescein angiogram shows typically early-stage hypofluorescent placoid areas and late-stage hyperfluorescent lesions.

It resolves in weeks to months but leaves scattered areas of RPE atrophy and hyperplasia.

Differential Diagnosis:

• Multifocal Choroiditis
• Sarcoidosis
• Vogt-Koyanagi-Harada disease
• White Dot Syndromes