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MULTIMODAL IMAGING OF ACUTE EXUDATIVE POLYMORPHOUS VITELLIFORM MACULOPATHY WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND ADAPTIVE OPTICS SCANNING LASER OPHTHALMOSCOPY

Skondra, Dimitra, MD, PhD*; Nesper, Peter L., BA; Fawzi, Amani A., MD

Retinal Cases and Brief Reports: July 2019 - Volume 13 - Issue 3 - p 195–198
doi: 10.1097/ICB.0000000000000591
Case Report
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Purpose: To report a case of acute exudative polymorphous vitelliform maculopathy including the findings of optical coherence tomography angiography and adaptive optics scanning laser ophthalmoscopy.

Methods: Findings on clinical examination, color fundus photography, spectral-domain optical coherence tomography, infrared reflectance, autofluorescence, optical coherence tomography angiography, and adaptive optics scanning laser ophthalmoscopy.

Results: A 54-year-old white man with no significant medical history and history of smoking presented with bilateral multiple serous and vitelliform detachments consistent with acute exudative polymorphous vitelliform maculopathy. Extensive infectious, inflammatory, and malignancy workup was negative. Spectral-domain optical coherence tomography showed thickened, hyperreflective ellipsoid zone, subretinal fluid, and focal as well as diffuse subretinal hyperreflective material corresponding to the vitelliform lesions. Optical coherence tomography angiography showed normal retinal and choroidal vasculature, whereas adaptive optics scanning laser ophthalmoscopy showed circular focal “target” lesions at the level of the photoreceptors in the area of foveal detachment.

Conclusion: Multimodal imaging is valuable in evaluating patients with acute exudative polymorphous vitelliform maculopathy.

Acute exudative polymorphous vitelliform maculopathy (AEPVM) is a rare entity of unknown etiology. The authors present a case of AEPVM including the findings of multimodal imaging with optical coherence tomography angiography and adaptive optics scanning laser ophthalmoscopy in addition to spectral-domain optical coherence tomography and autofluorescence.

*Retina Service, Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois; and

Retina Service, Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Reprint requests: Amani A. Fawzi, MD, Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Avenue, Suite 440, Chicago, IL 60611; e-mail: afawzimd@gmail.com

Research instrument support was provided by Boston Micromachines Corporation and Optovue, Inc.

None of the authors has conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.