Acute posterior multifocal placoid pigment epitheliopathy versus vogt-koyanagi-harada disease: Tomographic characteristics

Objective: to report a case of a male patient with acute posterior multifocal placoid pigment epitheliopathy (apmppe) mimicking acute vogt-koyanagi-harada (vkh) disease,discuss imaging findings and review pertinent tomography literature contributing to this diagnostic challenge. case report: a twenty six year-old male presented with bilateral blurring of vision for 2 weeks,for which he underwent full ophthalmologic examination,laboratory evaluation,b-scan ultrasonography,fluorescein angiography and spectral domain optical coherence tomography (oct). oct disclosed multifocal intra-retinal lobulated cystic fluid collections with septae of variable thickness,disruption of the photoreceptor layer with choroidal thickening and hyper-reflectance in outer retinal layers. conclusions: apmppe and acute vkh can present with substantial overlap in symptoms,signs and ophthalmic imaging characteristics. oct offers valuable information about both shared and different features. a holistic approach is necessary to reach a proper diagnosis and plan treatment and follow up.