Persistent placoid maculopathy: long term outcomes and prognostic factors

PURPOSE: To evaluate the long-term visual outcomes, recurrence, complication rate, and systemic associations of persistent placoid maculopathy (PPM). We also aimed to identify predictors of final visual acuity. METHODS: This study combined a retrospective multicenter case series from three tertiary referral centers with a systematic review of the literature. Inclusion criteria were bilateral placoid macular lesions with characteristic multimodal imaging findings and a minimum follow-up of 23 months. Visual acuity, systemic associations, complications, recurrence, and treatments were assessed. RESULTS: Twenty-three patients (46 eyes) were included, 6 patients from our centers and 17 patients from the literature. The median follow-up was 3.75 years. Severe visual loss (< 20/100) at final follow-up was observed in one third of eyes. Choroidal neovascularization occurred in 65.2% of eyes and recurrence in 21.7%. Systemic cardiovascular comorbidities were common (87.5%) and two patients presented cerebral vasculitis. Systemic treatment was significantly associated with better final visual acuity (p = 0.014). CONCLUSION: PPM presents a high complication rate and poor visual prognosis. Systemic treatment was significantly associated with better final visual acuity in our study.