Unilateral acute posterior multifocal placoid pigment epitheliopathy in a patient with a strongly positive purified protein derivative test

Arq Bras Oftalmol. 2019 Aug 29;82(5):432-435. doi: 10.5935/0004-2749.20190084.


A 27-year-old man presented with a complaint of decreased visual acuity in the right eye. Best-corrected visual acuity was 20/60 in the right eye and 20/20 in the left eye. Right eye fundoscopy revealed mild vitritis, multifocal yellowish lesions, and macular serous retinal detachment. Left eye evaluation was normal. Acute posterior multifocal placoid pigment epitheliopathy was diagnosed in the right eye. Complementary exams revealed a strong reaction to the Mycobacterium tuberculosis purified protein derivative test, thus treatment for tuberculosis was initiated. Baseline fluorescein angiography of the right eye revealed early hypofluorescence and late staining of the lesions. Optical coherence tomography of the right eye demonstrated the accumulation of subretinal and intraretinal fluid associated with cystoid macular edema. During follow-up, the retinal fluid and cysts disappeared, which was followed by disorganization of foveal interdigitation and ellipsoid zones. This is the second described case of unilateral acute posterior multifocal placoid pigment epitheliopathy in a patient with a strong positive result to the M. tuberculosis purified protein derivative test.

Publication types

  • Letter

MeSH terms

  • Acute Disease
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Antibiotics, Antitubercular / therapeutic use
  • Fluorescein Angiography
  • Humans
  • Male
  • Pigment Epithelium of Eye / diagnostic imaging*
  • Prednisone / therapeutic use
  • Retinal Diseases / diagnosis*
  • Retinal Diseases / drug therapy
  • Tomography, Optical Coherence
  • Tuberculosis, Ocular / diagnosis*
  • Tuberculosis, Ocular / drug therapy
  • Visual Acuity


  • Anti-Inflammatory Agents
  • Antibiotics, Antitubercular
  • Prednisone