Cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16-year-old male
Purpose: To report on a case of the successful treatment of Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) in a pediatric patient with a prior diagnosis of cerebral vasculitis. Observations: A 16-year-old male with a prior diagnosis of cerebral vasculitis presented without ocular...
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Elsevier
2024-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624001166 |
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| author | Sofía C. Ayala Rodríguez Estefania Ramirez Marquez Ángel G. Torres-Rosa Jerome A. Ramirez Marquez Roberto Boada Armando L. Oliver Ricardo E. Rodríguez-Rosa |
| author_facet | Sofía C. Ayala Rodríguez Estefania Ramirez Marquez Ángel G. Torres-Rosa Jerome A. Ramirez Marquez Roberto Boada Armando L. Oliver Ricardo E. Rodríguez-Rosa |
| author_sort | Sofía C. Ayala Rodríguez |
| collection | DOAJ |
| description | Purpose: To report on a case of the successful treatment of Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) in a pediatric patient with a prior diagnosis of cerebral vasculitis. Observations: A 16-year-old male with a prior diagnosis of cerebral vasculitis presented without ocular complaints. Visual acuity was 20/20, and color vision remained normal. Fundus examination revealed yellowish-white placoid lesions and retinal pigmented epithelial changes involving the posterior pole. A work-up including a rapid plasma reagin test, complete cell blood count, comprehensive metabolic panel, and urinalysis was within normal limits. A head computed tomography angiography without contrast and a brain magnetic resonance imaging scan were compatible with acute and past episodes of ischemia. Ancillary testing was compatible with an assessment APMPPE. Immunosuppressive and monoclonal antibody therapy resulted in the improvement and remission without residual neurologic deficits and with a BCVA of 20/20. Conclusionand Importance: This case suggests that a diagnosis of cerebral vasculitis should prompt physicians to consider an ophthalmic evaluation that includes a dilated fundus exam, regardless of the presence or absence of ocular symptoms. Ophthalmic findings may affect the diagnostic processes, particularly concerning infectious and non-infectious etiologies, or potentially neoplastic diseases. |
| format | Article |
| id | doaj-art-04d59f5cb8f94af49bb2926b9d65d0b6 |
| institution | OA Journals |
| issn | 2451-9936 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-04d59f5cb8f94af49bb2926b9d65d0b62025-08-20T01:57:51ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-013610210610.1016/j.ajoc.2024.102106Cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16-year-old maleSofía C. Ayala Rodríguez0Estefania Ramirez Marquez1Ángel G. Torres-Rosa2Jerome A. Ramirez Marquez3Roberto Boada4Armando L. Oliver5Ricardo E. Rodríguez-Rosa6University of Puerto Rico Medical Sciences Campus, Department of Ophthalmology, Paseo Dr. Jose Celso Barbosa, San Juan, PR, USAUniversity of Puerto Rico Medical Sciences Campus, Department of Ophthalmology, Paseo Dr. Jose Celso Barbosa, San Juan, PR, USAUniversity of Puerto Rico Medical Sciences Campus, Department of Ophthalmology, Paseo Dr. Jose Celso Barbosa, San Juan, PR, USAUniversity of South Alabama, College of Medicine, Department of Radiology, Mobile, AL, USAUniversity of Puerto Rico Medical Sciences Campus, Department of Ophthalmology, Paseo Dr. Jose Celso Barbosa, San Juan, PR, USAUniversity of Puerto Rico Medical Sciences Campus, Department of Ophthalmology, Paseo Dr. Jose Celso Barbosa, San Juan, PR, USAUniversity of Puerto Rico Medical Sciences Campus, Department of Ophthalmology, Paseo Dr. Jose Celso Barbosa, San Juan, PR, USAPurpose: To report on a case of the successful treatment of Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) in a pediatric patient with a prior diagnosis of cerebral vasculitis. Observations: A 16-year-old male with a prior diagnosis of cerebral vasculitis presented without ocular complaints. Visual acuity was 20/20, and color vision remained normal. Fundus examination revealed yellowish-white placoid lesions and retinal pigmented epithelial changes involving the posterior pole. A work-up including a rapid plasma reagin test, complete cell blood count, comprehensive metabolic panel, and urinalysis was within normal limits. A head computed tomography angiography without contrast and a brain magnetic resonance imaging scan were compatible with acute and past episodes of ischemia. Ancillary testing was compatible with an assessment APMPPE. Immunosuppressive and monoclonal antibody therapy resulted in the improvement and remission without residual neurologic deficits and with a BCVA of 20/20. Conclusionand Importance: This case suggests that a diagnosis of cerebral vasculitis should prompt physicians to consider an ophthalmic evaluation that includes a dilated fundus exam, regardless of the presence or absence of ocular symptoms. Ophthalmic findings may affect the diagnostic processes, particularly concerning infectious and non-infectious etiologies, or potentially neoplastic diseases.http://www.sciencedirect.com/science/article/pii/S2451993624001166Acute posterior multifocal placoid pigment epitheliopathyStrokesCerebral vasculitisRetina |
| spellingShingle | Sofía C. Ayala Rodríguez Estefania Ramirez Marquez Ángel G. Torres-Rosa Jerome A. Ramirez Marquez Roberto Boada Armando L. Oliver Ricardo E. Rodríguez-Rosa Cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16-year-old male American Journal of Ophthalmology Case Reports Acute posterior multifocal placoid pigment epitheliopathy Strokes Cerebral vasculitis Retina |
| title | Cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16-year-old male |
| title_full | Cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16-year-old male |
| title_fullStr | Cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16-year-old male |
| title_full_unstemmed | Cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16-year-old male |
| title_short | Cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16-year-old male |
| title_sort | cerebral vasculitis presenting as acute posterior multifocal placoid pigment epitheliopathy in a 16 year old male |
| topic | Acute posterior multifocal placoid pigment epitheliopathy Strokes Cerebral vasculitis Retina |
| url | http://www.sciencedirect.com/science/article/pii/S2451993624001166 |
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