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...

Full description

Saved in:
Bibliographic Details
Main Authors: Peggy Bouzika, Ilias Georgalas, Maria-Evanthia Sotirianakou, Aristotelis Karamaounas, Chrysanthos Symeonidis, Konstantinos Tyrlis, Stylianos Blounas, Ekaterini Mani, Tryfon Rotsos
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2022/9124630
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849400041261760512
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
work_keys_str_mv AT peggybouzika peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity
AT iliasgeorgalas peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity
AT mariaevanthiasotirianakou peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity
AT aristoteliskaramaounas peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity
AT chrysanthossymeonidis peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity
AT konstantinostyrlis peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity
AT stylianosblounas peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity
AT ekaterinimani peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity
AT tryfonrotsos peripapillarypachychoroidsyndromeppsdiagnosingandtreatingarareentity