Carreño, Ester;
Maghsoudlou, Panayiotis;
Fonollosa, Alejandro;
Leal, Inês;
Schlaen, Ariel;
Abraham, Alan Roy;
Dick, Andrew D;
... Multimodal Imaging in Uveitis (MUV), Taskforce; + view all
(2025)
Evidence and Consensus Based Guidelines for Imaging in Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) - Multimodal imaging in Uveitis (MUV) Taskforce: Report 7.
American Journal of Ophthalmology
10.1016/j.ajo.2025.06.007.
(In press).
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Abstract
PURPOSE: To develop consensus-based guidelines on use and interpretation of multimodal imaging in acute posterior multifocal placoid pigment epitheliopathy (APMPPE). DESIGN: Consensus agreement led by literature, and an expert committee using a nominal group technique (NGT). METHODS: The expert committee for APMPPE performed a thorough review of representative cases of APMPPE. The cases were used to develop guidelines for the diagnosis and follow-up of APMPPE using color fundus photography (CFP), optical coherence tomography (OCT), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), and OCT angiography (OCTA). Structured NGT-based discussions were used to achieve consensus-based recommendations on imaging characteristics, disease activity, and complications, and subsequently were adopted by a vote of the entire taskforce. RESULTS: Diagnosis of active APMPPE is characterized by distinctive imaging findings on CFP, and hyper-reflectivity of the ellipsoid zone (EZ), external limiting membrane (ELM), and outer nuclear layer (ONL) on OCT. Choriocapillaris non-perfusion, detectable via early-phase FFA, ICGA or OCTA, is crucial. In the early stages of APMPPE, OCT findings may be unremarkable, making FFA, ICGA, and/or OCTA relevant for the diagnosis. Based on the imaging findings, APMPPE can be classified into four stages of activity: choroidal, chorioretinal, transitional, and resolved. Following diagnosis, OCT and OCTA can be used to monitor lesion activity and identify potential complications. CONCLUSIONS: MUV imaging criteria enable the identification of key diagnostic features for APMPPE, extending the Standardization of Uveitis Nomenclature (SUN) classification. These consensus-based guidelines provide a framework for evaluating disease activity and complications, enhancing diagnostic accuracy and guiding clinical management.
| Type: | Article |
|---|---|
| Title: | Evidence and Consensus Based Guidelines for Imaging in Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) - Multimodal imaging in Uveitis (MUV) Taskforce: Report 7 |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ajo.2025.06.007 |
| Publisher version: | https://doi.org/10.1016/j.ajo.2025.06.007 |
| Language: | English |
| Additional information: | © 2025 The Authors. Published by Elsevier Inc. User License: Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Acute posterior multifocal placoid pigment epitheliopathy, activity, multimodal imaging, posterior uveitis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10210004 |
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