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

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.