Peripapillary Pachychoroid Syndrome (PPS): Diagnosing and Treating a Rare Entity
Two cases with peripapillary pachychoroid syndrome (PPS) along with the challenges concerning correct diagnosis and treatment are presented. In the first case, the patient presented with painless unilateral gradual visual loss. Fundoscopy and optical coherence tomography (OCT) revealed cystoid macul...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Ophthalmological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2022/9124630 |
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| author | Peggy Bouzika Ilias Georgalas Maria-Evanthia Sotirianakou Aristotelis Karamaounas Chrysanthos Symeonidis Konstantinos Tyrlis Stylianos Blounas Ekaterini Mani Tryfon Rotsos |
| author_facet | Peggy Bouzika Ilias Georgalas Maria-Evanthia Sotirianakou Aristotelis Karamaounas Chrysanthos Symeonidis Konstantinos Tyrlis Stylianos Blounas Ekaterini Mani Tryfon Rotsos |
| author_sort | Peggy Bouzika |
| collection | DOAJ |
| description | Two cases with peripapillary pachychoroid syndrome (PPS) along with the challenges concerning correct diagnosis and treatment are presented. In the first case, the patient presented with painless unilateral gradual visual loss. Fundoscopy and optical coherence tomography (OCT) revealed cystoid macular edema (CME) in the left eye (LE), extending from the temporal optic disc margin towards the fovea, with no additional findings. Enhanced-depth imaging- (EDI-) OCT provided additional information and increased choroidal thickness nasally to the macula and pachyvessels in the outer choroidal layer, findings supportive of PPS. Photodynamic therapy (PDT) was applied at the leakage sites. Two months later, CME and subretinal fluid (SRF) had resolved, and VA had significantly improved. In the second case, a patient presented with reduced vision and metamorphopsia bilaterally over the previous 5 days. Fundoscopy revealed CME in both eyes. OCT confirmed the presence of CME in the papillomacular area in the right eye; similarly, CME was recorded in the macula of the LE with SRF located subfoveally. EDI-OCT showed increased choroidal thickness in both eyes. Treatment was administered, originally with dorzolamide eye drops along with eplerenone tablets, and then dexamethasone eye drops that eventually led to significant anatomic and functional improvement. It is important for ophthalmologists to be able to recognize the unique clinical entity of PPS, as its resemblance to disorders with similar features may lead to misdiagnoses and unnecessary, or even incorrect, interventions. |
| format | Article |
| id | doaj-art-a03fac0a42e049f9a9da8e9073aa581a |
| institution | Kabale University |
| issn | 2090-6730 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Ophthalmological Medicine |
| spelling | doaj-art-a03fac0a42e049f9a9da8e9073aa581a2025-08-20T03:38:11ZengWileyCase Reports in Ophthalmological Medicine2090-67302022-01-01202210.1155/2022/9124630Peripapillary Pachychoroid Syndrome (PPS): Diagnosing and Treating a Rare EntityPeggy Bouzika0Ilias Georgalas1Maria-Evanthia Sotirianakou2Aristotelis Karamaounas3Chrysanthos Symeonidis4Konstantinos Tyrlis5Stylianos Blounas6Ekaterini Mani7Tryfon Rotsos8Retina ServiceRetina ServiceRetina ServiceRetina ServiceRetina ServiceRetina ServiceRetina ServiceRetina ServiceRetina ServiceTwo cases with peripapillary pachychoroid syndrome (PPS) along with the challenges concerning correct diagnosis and treatment are presented. In the first case, the patient presented with painless unilateral gradual visual loss. Fundoscopy and optical coherence tomography (OCT) revealed cystoid macular edema (CME) in the left eye (LE), extending from the temporal optic disc margin towards the fovea, with no additional findings. Enhanced-depth imaging- (EDI-) OCT provided additional information and increased choroidal thickness nasally to the macula and pachyvessels in the outer choroidal layer, findings supportive of PPS. Photodynamic therapy (PDT) was applied at the leakage sites. Two months later, CME and subretinal fluid (SRF) had resolved, and VA had significantly improved. In the second case, a patient presented with reduced vision and metamorphopsia bilaterally over the previous 5 days. Fundoscopy revealed CME in both eyes. OCT confirmed the presence of CME in the papillomacular area in the right eye; similarly, CME was recorded in the macula of the LE with SRF located subfoveally. EDI-OCT showed increased choroidal thickness in both eyes. Treatment was administered, originally with dorzolamide eye drops along with eplerenone tablets, and then dexamethasone eye drops that eventually led to significant anatomic and functional improvement. It is important for ophthalmologists to be able to recognize the unique clinical entity of PPS, as its resemblance to disorders with similar features may lead to misdiagnoses and unnecessary, or even incorrect, interventions.http://dx.doi.org/10.1155/2022/9124630 |
| spellingShingle | Peggy Bouzika Ilias Georgalas Maria-Evanthia Sotirianakou Aristotelis Karamaounas Chrysanthos Symeonidis Konstantinos Tyrlis Stylianos Blounas Ekaterini Mani Tryfon Rotsos Peripapillary Pachychoroid Syndrome (PPS): Diagnosing and Treating a Rare Entity Case Reports in Ophthalmological Medicine |
| title | Peripapillary Pachychoroid Syndrome (PPS): Diagnosing and Treating a Rare Entity |
| title_full | Peripapillary Pachychoroid Syndrome (PPS): Diagnosing and Treating a Rare Entity |
| title_fullStr | Peripapillary Pachychoroid Syndrome (PPS): Diagnosing and Treating a Rare Entity |
| title_full_unstemmed | Peripapillary Pachychoroid Syndrome (PPS): Diagnosing and Treating a Rare Entity |
| title_short | Peripapillary Pachychoroid Syndrome (PPS): Diagnosing and Treating a Rare Entity |
| title_sort | peripapillary pachychoroid syndrome pps diagnosing and treating a rare entity |
| url | http://dx.doi.org/10.1155/2022/9124630 |
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