Persistent placoid maculopathy associated with cerebral vasculitis
Purpose
To describe a case report of persistent placoid maculopathy (PPM) associated with cerebral vasculitis
Methods
Patient managed at a tertiary eye care center since december 2020 was included
Results
A 46-year-old patient presented a severe bilateral visual impairment and bilateral central scotoma, occurring after 7-day febrile episode and headache, in Israel. Visual acuity was 20/200 in the right eye and 20/63 in the left eye. There is a first diagnosis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE). He was treated with intravenous pulses of methylprednisolone followed by oral corticosteroids. Two weeks later, he presented a sensory disorder of the left hemisphere and a dysexecutive syndrome, due to a cerebral vasculitis. He was treated with intravenous cyclophosphamide. Despite immunosuppressive treatment, he had a cerebral progression and was addressed to a tertiary eye care center in Paris. Multimodal imaging reveals a bilateral and symmetric PPM. All extensive etiological investigation were negative, even brain biopsy, but quantiFERON-TB Gold was positive and confirmed a latent tuberculosis infection. Patient received only antitubercular treatment and oral corticosteroids. He had no recurrence of cerebral vasculitis nor posterior uveitis of PPM.
Conclusion
Persistent placoid maculopathy is a rare condition, and only one case reported an association with a cerebral vasculitis whereas it has been more frequently found in APMPPE. Etiological diagnosis is difficult, and latent tuberculosis should be investigated before immunosuppressive therapy.
Conflict of interest
No
Authors 1
Last name
TOUTÉE
Initials of first name(s)
A
Department
Ophthalmology
City
Paris
Country
France
Authors 2
Last name
HOURY
Initials of first name(s)
R
Department
Ophthalmology
City
Paris
Country
France
Authors 3
Last name
SAADOUN
Initials of first name(s)
D
Department
Internist
City
Paris
Country
France
Authors 4
Last name
PAQUES
Initials of first name(s)
M
Department
Ophthalmology
City
Paris
Country
France
Authors 5
Last name
BODAGHI
Initials of first name(s)
B
Department
Ophthalmology
City
Paris
Country
France
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