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Acute posterior multifocal placoid pigment epitheliopathy following varicella vaccination
  1. Howard F Fine,
  2. Esther Kim,
  3. Thomas E Flynn,
  4. Nuno L Gomes,
  5. Stanley Chang
  1. Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, USA
  1. Correspondence to Dr Howard F Fine, Medical Director of the Gerstner Clinical Research Center, Department of Ophthalmology, Columbia University College of Physicians and Surgeons, 635 West 165th Street, New York, NY 10032, USA; h_f_fine{at}yahoo.com

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Clinical presentation

An 11-year-old Caucasian girl with no past ocular history complained of blurry vision and photopsias 10 days following varicella vaccination with Varivax. She was referred to the retina service by her primary ophthalmologist 3 weeks later. On examination, the best-corrected visual acuity was 20/70 in the right eye and 20/150 in the left eye. The anterior segments were normal bilaterally. There was no vitritis. Fundus examination (figure 1A,B) revealed multiple discrete flat subretinal yellow-white plaques in the posterior pole with areas of retinal pigment epithelium (RPE) hyperpigmentation, consistent with evolving APMPPE. Fundus autofluorescence imaging (figure …

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