Diffuse posterior punctate pigment epitheliopathy.

Abstract

To describe the funduscopic and fluorescein findings of an unusual variant of an inflammatory chorioretinopathy, which is descriptively labeled as diffuse posterior punctate pigment epitheliopathy (DPPPE). The funduscopic and fluorescein angiogram findings in a case involving a 35-year-old man with sudden onset of decreased vision during a 2-year period are discussed. A 35-year-old man with sudden visual loss presented with bilateral macular lesions. These lesions were initially well-circumscribed hypopigmented areas, which, over the course of 2 years, developed significant atrophic changes with pigmentary migration. The patient also developed peripheral retinal findings of progressive linear punched-out lesions, and a peripheral serous retinal detachment. This case, although somewhat similar to previously described cases of inflammatory chorioretinopathies, is unique in its presentation and course. The possible pathophysiologic characteristics are discussed, and the descriptive label of diffuse posterior punctate epitheliopathy is used to assist in the recognition of future cases.