Sixteen patients, seen during the first week of their disease, had swelling of the retinal pigment epithelium and angiographic evidence of a widespread abnormality of choroidal filling. The patients fell into three groups: In Group 1 there were multifocal pigment epithelial lesions identical to those of acute posterior multifocal placoid pigment epitheliopathy. In Group 2 the pigment epithelial lesions were confluent. The retina was not detached in either of the these groups. In Group 3, multifocal lesions of the pigment epithelium were associated with retinal detachment. We postulated that all patients had diffuse choroidal hypoperfusion and focal pigment epithelial infarct which, in turn, may have been caused by a variety of basic disorders. We detected no relevant systemic abnormalities in any of the patients.