Unveiling a new clinical entity

Persistent placoid maculopathy has features resembling macular serpiginous choroiditis but differs in its clinical course and effect on visual acuity (VA), according to a study published in the August issue of Ophthalmology.

Pamela Golchet and colleagues from Northwestern University, Chicago, USA conducted a retrospective, observational case series to describe a previously unreported clinical entity that superficially resembles macular serpiginous choroiditis. A total of six patients, exhibiting this entity, were seen at five different centres between 1984 and 2006.

The researchers found that the lesions found in the study group patients, are similar to those of acute macular serpiginous choroiditis. The subjects had well-delineated whitish plaque-like lesions involving the macula and sparing the peripapillary areas of both eyes. Unlike serpiginous choroiditis, VA remained good despite early involvement of the fovea until complications related to choroidal neovascularisation or pigmentary mottling developed.

Fluorescein angiography exposed well-defined early hypofluorescent areas that partially filled in the late phase. In contrast to serpiginous choroiditis, the white macular lesions faded over a period of months to years, whereas the characteristic angiographic findings often persisted longer. Choroidal neovascularisation developed in 11 of the 12 eyes, later turning into disciform macular scars in nine of the 12 eyes.

The authors of this study found that, despite similarities to macular serpiginous choroiditis, persistent placoid maculopathy differs in its course and effect on VA.