Munjid Al Mousa
Jordanian Doctors Eyes Association, Jordan
Title: Borreliosis as a possible etiological factor in Acute Posterior Multifocal Placoid Pigment Epitheliopathy
Biography
Biography: Munjid Al Mousa
Abstract
Background: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an uncommon disorder of unknown etiology affecting the retina of the eye, retinal pigment epithelium and the choroid. Until now, no definite etiological factor has been found. We report a case of APMPPE associated with acute infection of Borreliosis.
Case Report: A 30-year-old man presented with a decrease in vision in the right eye of a few days duration. Examination of the right retina revealed the presence of multiple placoid creamy retinal/sub-retinal lesions. APMPPE was suspected and Fundus fluorescein angiography supported the diagnosis. IgM for Borrelia turned out positive and this supported the presence of a concomitant acute Borreliosis infection. The patient received oral Prednisone therapy and Amoxicillin. There was complete resolution of symptoms and signs after six weeks of treatment.
Conclusion: The possibility of Borreliosis as a possible etiological factor in the pathogenesis of APMPPE has not been thoroughly investigated. The biggest study that was done about this relation was by Wolf et al., in 1992. The authors of that study concluded that no such relation existed. However, several cases have been reported in the literature since then, including ours. We emphasize on the importance of doing newer studies about the subject, using more modern diagnostic techniques. We also emphasize that the clinician should be aware of this relation and should test patients who present with APMPPE for Borrelia antibodies as this may guide the treatment and may spare the patient from many complications.