Indocyanine Green Video Angiographic Findings in Acute Posterior Multifocal Placoid Pigment Epitheliopathy

Abstract

The placoid lesions of acute posterior multifocal placoid pigment epitheliopathy consist of two distinct areas: a light yellow area surrounding a dark yellow center. On two occasions, the authors compared indocyanine green video angiographic with fluorescein angiographic findings in a typical case of acute posterior multifocal placoid pigment epitheliopathy. In the acute stage, the multiple placoid lesions observed in the early phase of indocyanine green video-angiography showed hypofluorescent lesions corresponding to those seen with fluorescein angiography which blocked choroidal vessels. Some fluorescent intermediate sized choroidal vessels, which traversed the hypofluorescent areas, were dark due to a slight degree of blocked fluorescence. On both indocyanine green video and fluorescein angiography, hypofluorescent lesions were almost the same size as the light yellow area and the dark yellow center of a placoid lesion. A hypofluorescent lesion, seen on fluorescein angiography, obscured a retinal vessel. When the placoid lesions had disappeared, fewer hypofluorescent lesions, corresponding to some of the hypofluorescent lesions originally observed, were seen in the early phase of indocyanine green video angiography. They were also smaller in size. These hypofluorescent lesions decreased in size and some had completely disappeared in the late phase. No hypofluorescent lesions were seen in the early phase of fluorescein angiography. Findings in the acute stage suggest that the hypofluorescence observed in the early phase of indocyanine green video and fluorescein angiography is mainly blockage due to a light yellow area of placoid. When the placoid lesion disappeared, filling delays, which were detectable on only indocyanine green video angiography, persisted in the choriocapillaris.