Researchers describe possible new ocular disease: persistent placoid maculopathy

Persistent placoid maculopathy may be a new entity resembling macular serpiginous choroiditis, but differing in its clinical course and effect on vision, according to a small study. Most affected eyes develop choroidal neovascularization resulting in loss of central vision, the authors noted.

Pamela R. Golchet, MD, and colleagues at five U.S. centers reviewed six patients aged 50 to 68 years who developed this macular condition between 1984 and 2006. They reported the clinical features of the maculopathy in the August issue of Ophthalmology.

The six patients had well-delineated, whitish, plaque-like lesions affecting the macula but sparing the peripapillary areas of both eyes. These lesions were similar to those characteristic of acute macular serpiginous choroiditis.

However, in contrast to serpiginous choroiditis, patients maintained good visual acuity, despite early foveal involvement, "until complications related to choroidal neovascularization or pigmentary mottling developed," the authors reported.

Patients also had atypical angiographic characteristics and a differing clinical course compared with serpiginous choroiditis. Specifically, patients showed well-defined, early hypofluorescent areas on fluorescein angiography, which partially filled in during the late phase, according to the study.

Indocyanine green angiography also revealed that the hypofluorescence remains persistent, the authors noted.

Additionally, the white macular lesions faded over several months to years, although the angiographic findings often persisted longer, they reported.

Choroidal neovascularization developed in 11 of 12 eyes and subsequently converted to disciform macular scars in nine eyes, according to the study.

"Unlike serpiginous choroiditis, none of the eyes showed chorioretinal scar formation unless related to choroidal neovascularization," the authors noted.