A Case of Acute Posterior Multifocal Placoid Pigment Epitheliopathy Following Human Papilloma Virus Vaccination.

Lee, Jae Hyuck; Kim, Hyun Tae; Bae, Jeong Hun

doi:2017.58.3.358

J Korean Ophthalmol Soc > Volume 58(3); 2017 > Article

Case Report

Journal of the Korean Ophthalmological Society 2017;58(3):358-362.
DOI: https://doi.org/10.3341/jkos.2017.58.3.358 Published online March 15, 2017.

A Case of Acute Posterior Multifocal Placoid Pigment Epitheliopathy Following Human Papilloma Virus Vaccination.

Jae Hyuck Lee, Hyun Tae Kim, Jeong Hun Bae

Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. jhbae94@hotmail.com

인유두종바이러스 백신 접종 후 발생한 급성후부다발판모양색소상피병증 1예

이재혁⋅김현태⋅배정훈

성균관대학교 의과대학 강북삼성병원 안과학교실

Correspondence: Jeong Hun Bae,
Email: jhbae94@hotmail.com

Received: 10 November 2016 • Revised: 27 December 2016 • Accepted: 17 February 2017

Abstract

PURPOSE
To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) that developed after human papilloma virus (HPV) vaccination. CASE SUMMARY: A 31-year-old woman experienced sudden bilateral blurred vision and paracentral scotomas four days before visiting the hospital. The symptoms occurred two weeks after the second vaccination with quadrivalent HPV vaccine (Gardasil®, MSD Korea, Seoul, Korea), and she had no pain or cold symptoms. At initial visit, the anterior chamber cells were observed, and the anterior vitreous was found to be clear. On fundus examination, multiple placoid yellow-whitish lesions were observed at the posterior pole, and fluorescein angiography showed early hypofluorescence and late hyperfluorescence with staining. Under a diagnosis of bilateral APMPPE, oral corticosteroid was used as treatment for two weeks, after which symptoms were resolved, anterior chamber cells disappeared, and lesions at the posterior pole markedly decreased. After five weeks, multiple hyperreflective areas on the outer retinal layers as well as missing photoreceptor and retinal pigment epithelial layers were almost recovered upon optical coherence tomography. CONCLUSIONS: Non-infectious uveitis such as APMPPE can rarely present after HPV vaccination. Further studies are necessary to understand whether HPV vaccine is a direct cause of uveitis.

Key Words: Acute posterior multifocal placoid pigment epitheliopathy;Human papilloma virus;Vaccination