Acute Posterior Multifocal Placoid Pigment Epitheliopathy Following Dengue Fever: A New Association for an Old Disease

Purpose: An association between antecedent viral illness and acute posterior multifocal placoid pigment epitheliopathy (APMPPE) has long been suspected. The authors propose dengue fever as a possible cause of APMPPE, based on three patients who travelled to or lived in endemic areas and had serologic evidence of prior exposure.

Methods: Review of case records of two patients.

Results: The index patient presented with APMPPE after her second confirmed dengue infection. A second patient with positive serology for dengue was subsequently identified, who had acute onset of posterior uveitis with APMPPE-like features. Dengue antibody titers were positive in both patients.

Conclusions: APMPPE may be another manifestation of dengue fever. Ophthalmologists should take travel histories and consider ordering dengue serology in appropriate patients with APMPPE even if fever is absent, and especially in patients with the possibility of attenuated systemic disease and a primarily immunologic reaction to subsequent exposure.