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

Purpose: To report a case of Acute Posterior Multifocal Placoid Pigment Epi theliopathy (APMPPE) in the course of Ulcerative Colitis (UC), Methods: A complete ophthalmologic evaluation, including fluorescein and in docyanine green angiography, was performed. Results: A patient with exacerbation of UC was referred to our department f or sudden visual loss in RE. Ophthalmoscopy disclosed multifocal yellow-whi te placoid lesions typical of APMPPE in RE. There were no lesions in the fe llow 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 lesion s observed clinically, and late anular staining surrounding a hypofluoresce nt lesion at the posterior pole. On LE ICGA revealed lesions not detected w ith ophthalmoscopy and FA, After corticosteroid therapy the lesions healed. Conclusion: Ulcerative Colitis may be responsible for the onset of AMPPPE b y an immunological mechanism of delayed type hypersensitivity reaction.