Acute posterior multifocal placoid pigment epitheliopathy and ulcerative colitis: A possible association

Purpose: To report a case of Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) in the course of Ulcerative Colitis (UC). Methods: A complete ophthalmologic evaluation, including fluorescein and indocyanine green angiography, was performed. Results: A patient with exacerbation of UC was referred to our department for sudden visual loss in RE. Ophthalmoscopy disclosed multifocal yellow-white placoid lesions typical of APMPPE in RE. There were no lesions in the fellow eye. On fluorescein angiography (FA), the active lesions showed early hypofluorescence, followed by late staining. Indocyanine green angiography (ICGA) revealed early and late hypofluorescence corresponding to the lesions observed clinically, and late anular staining surrounding a hypofluorescent lesion at the posterior pole. On LE ICGA revealed lesions not detected with ophthalmoscopy and FA. After corticosteroid therapy the lesions healed. Conclusion: Ulcerative Colitis may be responsible for the onset of AMPPPE by an immunological mechanism of delayed type hypersensitivity reaction.