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June 1992

Acute, Posterior, Multifocal, Placoid, Pigment Epitheliopathy and Lyme Disease

Author Affiliations

Iowa City, Iowa
Chicago, Ill

Arch Ophthalmol. 1992;110(6):750. doi:10.1001/archopht.1992.01080180020004

To the Editor.  —Acute, posterior, multifocal, placoid, pigment epitheliopathy (APMPPE) is an idiopathic chorioretinal inflammatory disease. Because a prodromal upper respiratory illness may frequently occur, a viral or other infectious etiology has been postulated. We recently reported a case of a woman with APMPPE whose mother and brother developed optic neuritis within 3 months of each other.1 We have noticed that APMPPE cases appear to occur in clusters. A previous report has suggested a possible association between an APMPPE-like chorioretinal inflammation and Lyme disease.2Lyme disease is a multisystem disorder caused by the tick-borne spirochete, Borrelia burgdorferi. This disease can cause a variety of ocular inflammations, including conjunctivitis, episcleritis, stromal keratitis, iridocyclitis, pars planitis, choroiditis, vitritis, and optic neuritis. Borrelia burgdorferi has been identified histopathologically in the retina and vitreous.3 We evaluated serum from a group of patients with APMPPE for evidence of antibodies directed against B

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