Relentless Placoid Chorioretinitis Associated With Central Nervous System Lesions Treated With Mycophenolate Mofetil

Published on Mar 9, 2009in Archives of Ophthalmology
· DOI :10.1001/ARCHOPHTHALMOL.2009.12
Steven Yeh33
Estimated H-index: 33
,
Julie C. Lew6
Estimated H-index: 6
+ 1 AuthorsRobert B. Nussenblatt99
Estimated H-index: 99
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#1Tadashi Orihara (Kyorin University)H-Index: 4
#2Toshiko Wakabayashi (Kyorin University)H-Index: 7
Last. Tetsuo Hida (Kyorin University)H-Index: 27
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Jones and colleagues described a clinical entity they called relentless placoid chorioretinitis, characterized by features similar to both acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginouschoroiditis, but with atypical features for either of these diseases. 1 Here we describe a young Japanese man with what we believe fits their description of relentless placoid chorioretinitis.
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#1B. Eric Jones (U of C: University of Chicago)H-Index: 1
#2Lee M. Jampol (U of C: University of Chicago)H-Index: 78
Last. David F. WilliamsH-Index: 25
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Objective: To characterize an unusual clinical entity resembling acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis but with an atypical clinical course. Patients: We describe 6 patients, aged 17 through 51 years, exhibiting this unusual entity who were seen at 6 different centers from 1984 to 1997. Results: The acute retinal lesions in this series were similar to those of APMPPE or serpiginous choroiditis, both clinically and on fluorescein and indocy...
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#1Guido Stoll (HHU: University of Düsseldorf)H-Index: 45
#2Karlheinz ReinersH-Index: 18
Last. H J FreundH-Index: 1
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In a patient with angiographically proven cerebral vasculitis five months after acute posterior multifocal placoid pigment epitheliopathy (APMPPE) neurological symptoms promptly responded to steroid treatment. Cerebrospinal fluid (CSF) showed a lymphocytic pleocytosis. Magnetic resonance imaging (MRI) revealed multifocal white matter lesions in the hemispheres and the brain stem suggesting a diffuse subcortical vasculitis.
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#1Joel M. WeinsteinH-Index: 17
#2Bresnick GhH-Index: 1
Last. Strother CmH-Index: 1
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: Acute multifocal posterior placoid pigment epitheliopathy (APMPPE) is an unusual self-limited retinal disorder that has been associated with various systemic complications. To our knowledge, three prior cases associated with cerebral vasculitis have been described. This article describes a patient with APMPPE and angiographically documented cerebral vasculitis who was notable because of (a) the presence of two different cerebral ischemic events, occurring 1 month apart, and (b) the long latenc...
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Placoid lesions of the retina may be secondary to a wide spectrum of acquired inflammatory conditions that have been reported as single entities with different presentation and clinical course. These conditions include acute posterior multifocal placoid pigment epitheliopathy, persistent placoid maculopathy, serpiginous choroiditis, serpiginous-like choroiditis, relentless placoid chorioretinitis and acute syphilitic posterior placoid chorioretinitis. In this article, we will group these conditi...
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Classification systems exist in uveitis based on the clinical course (acute, chronic or recurrent), etiology (infectious or noninfectious), laterality (unilateral or bilateral), histology (granulomatous or nongranulomatous), and primary anatomic location of inflammation. Classification based on the primary location of inflammation is critical in establishing a differential diagnosis and thereby treatment approach. Classification as intermediate, posterior, and panuveitis is based on the Standard...
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#2Rukhsana G. MirzaH-Index: 11
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#1Takehiko Uraki (Hokkaido University)H-Index: 2
#2Kenichi Namba (Hokkaido University)H-Index: 28
Last. Susumu Ishida (Hokkaido University)H-Index: 52
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Abstract Purpose Relentless placoid chorioretinitis (RPC) is a new disease concept that was proposed by Jones et al. in 2000. Some cases of RPC have been reported; however, a treatment strategy has not yet been established. We report herein four cases of patients diagnosed with RPC. Observations We experienced four cases of RPC in patients aged 24–51 years. All patients exhibited retinal lesions similar to that seen in acute posterior multifocal placoid pigment epitheliopathy or serpiginous chor...
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#1Eileen S. Hwang (UofU: University of Utah)H-Index: 6
#2James E. Bell (UofU: University of Utah)H-Index: 4
Last. Akbar Shakoor (UofU: University of Utah)H-Index: 9
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ABSTRACTPurpose: To report the first case of stroke in a patient with relentless placoid chorioretinitis.Methods: Observational case report.Results: A 20-year-old female with newly diagnosed relentless placoid chorioretinitis was urgently evaluated for unilateral paresthesias. She was found to have acute bilateral pontine strokes and cerebral vasculitis on magnetic resonance imaging of the brain and cerebral angiography.Conclusions: We report the first case of stroke due to cerebral vasculitis i...
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#1Frederick R. Burgess (Johns Hopkins University)H-Index: 1
#1Mohammad Ali Sadiq (Johns Hopkins University)H-Index: 16
Last. Jose S. PulidoH-Index: 64
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This case is submitted by Drs. Francisco J. Ascaso, Maria Rojo, and Enrique Minguez from the Department of Ophthalmology, “Lozano Blesa” University Clinic Hospital, Zaragoza, Spain, for the Diagnostic and Therapeutic Challenges Section of Retina; and commented by Dr. Steven M. Cohen, Clearwater, Flo
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#1D. B. Roth (UMDNJ: University of Medicine and Dentistry of New Jersey)H-Index: 5
#1Daniel B. Roth (UMDNJ: University of Medicine and Dentistry of New Jersey)H-Index: 18
Last. Howard F FineH-Index: 16
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PURPOSE: To report a case of relentless placoid chorioretinitis (ampiginous choroiditis) treated with intravitreal triamcinolone acetonide (IVTA). METHODS: Interventional case report. RESULTS: A 34-year-old pregnant woman with a history of poor visual acuity in her left eye, secondary to an undetermined cause, developed an acute painless central scotoma and blurred vision in the right eye. The examination revealed decreased visual acuity, active inflammatory placoid choroidal lesions in the post...
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Background The purpose of this study is to evaluate the retinal and choroidal thickness of the macular region in patients with unilateral relentless placoid chorioretinitis (RPC) and macular involvement. Patients diagnosed with RPC affecting only one eye underwent a comprehensive ophthalmologic examination including best-corrected visual acuity (BCVA), axial length (AL) measurement, slit-lamp examination, and color fundus and autofluorescence photography. The macular region was scanned by swept-...
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#1Hossein Nazari Khanamiri (SC: University of Southern California)H-Index: 5
#2Narsing A. Rao (SC: University of Southern California)H-Index: 81
Abstract Serpiginous choroiditis (SC) is a posterior uveitis displaying a geographic pattern of choroiditis, extending from the juxtapapillary choroid and intermittently spreading centrifugally. The choroiditis involves the overlying retinal pigment epithelium, and the outer retina. This intraocular inflammation typically involves both eyes in otherwise healthy, middle-aged individuals with no familial or ethnic predilection. Pathogenesis is unclear; based on limited histopathologic studies, how...
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