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Increased choroidal blood flow velocity with regression of acute posterior multifocal placoid pigment epitheliopathy

  • Clinical Investigation
  • Published:
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Abstract

Purpose

To quantitatively examine changes in choroidal circulation hemodynamics in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE).

Methods

Retrospective observational case series. Five eyes of 3 APMPPE patients were included. In all APMPPE eyes, laser speckle flowgraphy was conducted to evaluate the mean blur rate (MBR), a quantitative index of relative blood flow velocity. The changes in MBR at the initial visit and after 3 and 6 months were statistically analyzed. In 2 eyes, enhanced depth imaging optical coherence tomography was used to measure central choroidal thickness.

Results

In all eyes, multiple subretinal placoid lesions spontaneously regressed with recovery of outer retinal morphology. The average MBR significantly increased at 3 and 6 months after baseline at the fovea by 49.6 and 54.2 % and at the lesion site by 65.2 and 70.8 %, respectively. These changes at both regions during the 6-month follow-up were statistically significant (P = 0.02 for each). The mean central choroidal thickness decreased with time (518.0 µm at baseline to 344.5 µm at 6 months).

Conclusions

Our data revealed the significant elevation of choroidal blood flow velocity and the substantial reduction of choroidal thickness with regression of APMPPE, suggesting that impaired choroidal circulation is involved in the pathogenesis of APMPPE.

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References

  1. Gass JD. Acute posterior multifocal placoid pigment epitheliopathy. Arch Ophthalmol. 1968;80:177–85.

    Article  CAS  PubMed  Google Scholar 

  2. Agarwal A. Acute posterior multifocal placoid pigment epitheliopathy. In: Agarwal A, editor. Gass’ atlas of macular diseases. 5th ed. Edinburgh: Elsevier Saunders; 2012. p. 954–60.

    Google Scholar 

  3. Fiore T, Iaccheri B, Androudi S, Papadaki TG, Anzaar F, Brazitikos P, et al. Acute posterior multifocal placoid pigment epitheliopathy: outcome and visual prognosis. Retina. 2009;29:994–1001.

    Article  PubMed  Google Scholar 

  4. Goldenberg D, Habot-Wilner Z, Loewenstein A, Goldstein M. Spectral domain optical coherence tomography classification of acute posterior multifocal placoid pigment epitheliopathy. Retina. 2012;32:1403–10.

    Article  PubMed  Google Scholar 

  5. Mensah E, Vafidis GC. Acute posterior multifocal placoid pigment epitheliopathy in a 7-year-old girl. J Pediatr Ophthalmol Strabismus. 2002;39:239–41.

    PubMed  Google Scholar 

  6. Taich A, Johnson MW. A syndrome resembling acute posterior multifocal placoid pigment epitheliopathy in older adults. Retina. 2009;29:149–56.

    Article  PubMed  Google Scholar 

  7. Furusho F, Imaizumi H, Takeda M. One case of Harada disease complicated by acute posterior multifocal placoid pigment epitheliopathy-like recurrence in both eyes. Jpn J Ophthalmol. 2001;45:117–8.

    Article  PubMed  Google Scholar 

  8. Tanigawa M, Tsukahara Y, Yamanaka H. A case of acute posterior multifocal placoid pigment epitheliopathy demonstrating Vogt-Koyanagi-Harada disease-like optical coherence tomography findings in the acute stage. Case Rep Ophthalmol. 2013;11:172–9.

    Article  Google Scholar 

  9. Lee GE, Lee BW, Rao NA, Fawzi AA. Spectral domain optical coherence tomography and autofluorescence in a case of acute posterior multifocal placoid pigment epitheliopathy mimicking Vogt-Koyanagi-Harada disease: case report and review of literature. Ocul Immunol Inflamm. 2011;19:42–7.

    Article  PubMed  Google Scholar 

  10. Howe LJ, Woon H, Graham EM, Fitzke F, Bhandari A, Marshall J. Choroidal hypoperfusion in acute posterior multifocal placoid pigment epitheliopathy. An indocyanine green angiography study. Ophthalmology. 1995;102:790–8.

    Article  CAS  PubMed  Google Scholar 

  11. Spaide RF, Yannuzzi LA, Slakter J. Choroidal vasculitis in acute posterior multifocal placoid pigment epitheliopathy. Br J Ophthalmol. 1991;75:685–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. El-Markaby HS, Mohammed TH, El-Raggal TM. Acute posterior multifocal placoid pigment epitheliopathy: role of TNF blocker in severe cases. Retina. 2012;32:2102–7.

    Article  CAS  PubMed  Google Scholar 

  13. Hirano Y, Yasukawa T, Nagai H, Ogura Y. Spatio-temporal understanding of the pathology of acute posterior multifocal placoid pigment epitheliopathy. Jpn J Ophthalmol. 2012;56:371–4.

    Article  PubMed  Google Scholar 

  14. Tamaki Y, Araie M, Kawamoto E, Eguchi S, Fujii H. Noncontact, two-dimensional measurement of retinal microcirculation using laser speckle phenomenon. Invest Ophthalmol Vis Sci. 1994;35:3825–34.

    CAS  PubMed  Google Scholar 

  15. Sugiyama T. Basic technology and clinical applications of the updated model of laser speckle flowgraphy to ocular diseases. Photonics. 2014;1:220–34.

    Article  Google Scholar 

  16. Aizawa N, Yokoyama Y, Chiba N, Omodaka K, Yasuda M, Otomo T, et al. Reproducibility of retinal circulation measurements obtained using laser speckle flowgraphy-NAVI in patients with glaucoma. Clin Ophthalmol. 2011;5:1171–6.

    PubMed  PubMed Central  Google Scholar 

  17. Isono H, Kishi S, Kimura Y, Hagiwara N, Konishi N, Fujii H. Observation of choroidal circulation using index of erythrocytic velocity. Arch Ophthalmol. 2003;121:225–31.

    Article  PubMed  Google Scholar 

  18. Saito M, Saito W, Hashimoto Y, Yoshizawa C, Fujiya A, Noda K, et al. Macular choroidal blood flow velocity decreases with regression of acute central serous chorioretinopathy. Br J Ophthalmol. 2013;97:775–80.

    Article  PubMed  Google Scholar 

  19. Saito M, Saito W, Hashimoto Y, Yoshizawa C, Shinmei Y, Noda K, et al. Correlation between decreased choroidal blood flow velocity and the pathogenesis of acute zonal occult outer retinopathy. Clin Exp Ophthalmol. 2014;42:139–50.

    Article  Google Scholar 

  20. Hirooka K, Saito W, Namba K, Takemoto Y, Mizuuchi K, Uno T, et al. Relationship between choroidal blood flow velocity and choroidal thickness during systemic corticosteroid therapy for Vogt-Koyanagi-Harada disease. Graefes Arch Clin Exp Ophthalmol. 2015;253:609–17.

    Article  CAS  PubMed  Google Scholar 

  21. Hashimoto Y, Saito W, Saito M, Hirooka K, Mori S, Noda K, et al. Decreased choroidal blood flow velocity in the pathogenesis of multiple evanescent white dot syndrome. Graefes Arch Clin Exp Ophthalmol. 2015;253:1457–64.

    Article  PubMed  Google Scholar 

  22. Hashimoto Y, Saito W, Saito M, Hirooka K, Mori S, Noda K, et al. Increased choroidal blood flow velocity with regression of unilateral acute idiopathic maculopathy. Jpn J Ophthalmol. 2015;59:252–60.

    Article  CAS  PubMed  Google Scholar 

  23. Riva CE, Titze P, Hero M, Petrig BL. Effect of acute decreases of perfusion pressure on choroidal blood flow in humans. Invest Ophthalmol Vis Sci. 1997;38:1752–60.

    CAS  PubMed  Google Scholar 

  24. Okuno T, Sugiyama T, Kohyama M, Kojima S, Oku H, Ikeda T. Ocular blood flow changes after dynamic exercise in humans. Eye. 2006;20:796–800.

    Article  CAS  PubMed  Google Scholar 

  25. Schneider U, Inhoffen W, Gelisken F. Indocyanine green angiography in a case of unilateral recurrent posterior acute multifocal placoid pigment epitheliopathy. Acta Ophthalmol Scand. 2003;81:72–5.

    Article  PubMed  Google Scholar 

  26. Watanabe G, Fujii H, Kishi S. Imaging of choroidal hemodynamics in eyes with polypoidal choroidal vasculopathy using laser speckle phenomenon. Jpn J Ophthalmol. 2008;52:175–81.

    Article  PubMed  Google Scholar 

  27. Takahashi A, Saito W, Hashimoto Y, Saito M, Ishida S. Impaired circulation in the thickened choroid of a patient with serpiginous choroiditis. Ocul Immunol Inflamm. 2014;22:409–13.

    Article  PubMed  Google Scholar 

  28. Hirooka K, Saito W, Hashimoto Y, Saito M, Ishida S. Increased macular choroidal blood flow velocity and decreased choroidal thickness with regression of punctate inner choroidopathy. BMC Ophthalmol. 2014;14:73.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF. Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology. 2010;117:1792–9.

    Article  PubMed  Google Scholar 

  30. Yenerel NM, Gorgun E, Dinc UA, Oncel M. Treatment of cystoid macular edema due to acute posterior multifocal placoid pigment epitheliopathy. Ocul Immunol Inflamm. 2008;16:67–71.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Kiriko Hirooka, Wataru Saito, Michiyuki Saito, Yuki Hashimoto, Shohei Mori, Kousuke Noda & Susumu Ishida

  2. Department of Ocular Circulation and Metabolism, Hokkaido University Graduate School of Medicine, Nishi 7, Kita 15, Kita-ku, Sapporo, 060-8638, Japan

    Wataru Saito, Kousuke Noda & Susumu Ishida

Authors
  1. Kiriko Hirooka
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  2. Wataru Saito
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  3. Michiyuki Saito
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  4. Yuki Hashimoto
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  5. Shohei Mori
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  6. Kousuke Noda
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  7. Susumu Ishida
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Corresponding author

Correspondence to Wataru Saito.

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Conflicts of interest

K. Hirooka, None; W. Saito, None; M. Saito, None; Y. Hashimoto, None; S. Mori, None; K. Noda, None; S. Ishida, None.

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Hirooka, K., Saito, W., Saito, M. et al. Increased choroidal blood flow velocity with regression of acute posterior multifocal placoid pigment epitheliopathy. Jpn J Ophthalmol 60, 172–178 (2016). https://doi.org/10.1007/s10384-016-0440-6

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  • DOI: https://doi.org/10.1007/s10384-016-0440-6

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