RT Journal Article
SR Electronic
T1 Acute posterior multifocal placoid pigment epitheliopathy: clinical presentation and risk of stroke and transient ischaemic attack
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP bjophthalmol-2022-321517
DO 10.1136/bjo-2022-321517
A1 Rachael L Niederer
A1 Priya D Samalia
A1 Yi-Hsing Chen
A1 Jonathan KS Goh
A1 Elisa Eleanor Cornish
A1 Stephen Guest
A1 Peter J McCluskey
A1 Lyndell L Lim
A1 Joanne L Sims
A1 Susan Lightman
A1 Oren Tomkins-Netzer
YR 2023
UL http://bjo.bmj.com/content/early/2023/01/18/bjo-2022-321517.abstract
AB Background/aims Acute posterior multifocal placoid pigment epitheliopathy is a rare but important disease that can be associated with life-threatening complications due to cerebral vasculitis. The primary objective was to determine the incidence of neurological complications and risk factors for stroke and transient ischaemic attack (TIA) associated with acute posterior multifocal placoid pigment epitheliopathy. Secondary objectives included the clinical presentation, visual outcomes and recurrence rates.Methods This was a multicentre retrospective case series including 111 eyes from 60 subjects presenting from January 2009 to June 2020.Results Median age at presentation was 29 years (IQR 24.7–35.1) and 36 subjects (60.0%) were male. 20 subjects (33.3%) reported a viral prodrome. Stroke and TIA were observed in seven subjects (11.7%). Older age was the only significant risk factor for stroke/TIA (p=0.042). Vision loss occurred in seven eyes, with four eyes (3.6%) having final visual acuity 6/15–6/60 and three eyes (2.7%) having visual acuity of 6/60 or worse. Recurrence occurred in 10 subjects (16.7%).Conclusions The presence of headache cannot reliably predict those at risk of stroke/TIA. Individuals presenting with acute posterior multifocal pigment epitheliopathy should therefore undergo a clinical neurological review and work-up for cerebral vasculitis as deemed appropriate by the treating ophthalmologist and collaborating neurologist.No data are available.