Acute posterior multifocal placoid pigment epitheliopathy. Pigment epitheliopathy of choriocapillaritis?

Gass (I968) presented the clinical and fluorescein angiographic findings in three young female patients showing rapid loss of central vision secondary to multifocal, yellow-white, placoid lesions at the level of the pigment epithelium and choroid; rapid resolution of these lesions with permanent alterations in the pigment epithelium and minimal damage to the adjacent choroid and retina; and significant visual improvement after apparent ophthal- moscopic resolution of the acute lesion.The lesions were located at the posterior pole, and despite extensive general physical examination and blood studies no aetiology could be found.Gass wondered about the significance of a positive tuberculin skin test in two patients and of a family history of tuberculosis in the third patient.Maumenee (I970) reported having seen six patients with this condition and described it as one of the clinical entities discernible among the intraocular inflammations termed "uveitis".Van Buskirk, Lessell, and Friedman (I97I) described one patient with this condition who also had erythema nodosum.Little is known about this affection, and since we have observed three young females with almost identical lesions we thought it worthwhile to present their cases.The sig- nificance of erythema nodosum with histologically demonstrated vasculitis in one of our patients is discussed with regard to the primary site of this so-called acute posterior multi- focal placoid pigment epitheliopathy. Case reportsCase I, a 20-year-old white female, was admitted to the Rotterdam Eye Hospital on June 7, I968, with the complaint of seeing flecks in both eyes for a week. ExaminationThe visual acuity in both eyes was o-I and there was marked metamorphopsia.Both anterior chambers were clear, and the vitreous body showed a moderate number of cells in both eyes.The fundi showed multiple, generally round, whitish placoid patches with fuzzy margins scattered