MULTIMODAL IMAGING OF POSTERIOR POLAR ANNULAR CHOROIDAL DYSTROPHY

Posterior Polar Annular Choroidal Dystrophy: Genetic Insights and Differential Diagnosis in Inherited Retinal Diseases

Posterior polar annular choroidal dystrophy (PPACD) is a rare ocular disorder and presents as symmetric degeneration of the retinal pigment epithelium (RPE) and the underlying choriocapillaris, encircling the retinal vascular arcades and optic disc. This condition distinctively preserves the foveal region, optic disc, and the outermost regions of the retina. Despite its distinct clinical presentation, due to the infrequency of its occurrence and the limited number of reported cases, the pathophysiology, and the genetic foundations of PPACD are still largely uncharted. This review aims to bridge this knowledge gap by investigating potential genetic contributors to PPACD, assessing current findings, and identifying genes that warrant further study. Emphasis is also placed on the crucial role of multimodal imaging in diagnosing PPACD, highlighting its importance in understanding disease pathophysiology. By analyzing existing case reports and drawing comparisons with similar retinal disorders, this paper endeavors to delineate the possible genetic correlations in PPACD, providing a foundation for future genetic research and the development of targeted diagnostic strategies.

Retinal Neovascularization in Posterior Polar Annular Choroidal Dystrophy

This case report describes the development of posterior subcapsular cataract and retinal neovascularization in a patient with posterior polar annular choroidal dystrophy.

Insidious progression of atrophic lesions in a case of posterior polar annular choroidal dystrophy

Purpose

To describe the clinical course of a case of posterior polar annular choroidal dystrophy (PPACD) followed for 5 years.

Observations

A 64-year-old female patient presented with blurred vision. The patient had no subjective symptoms of night blindness or visual field defects. At the initial visit, the patient's visual acuity was 20/20 in both eyes. Bilateral fundus examination revealed atrophic lesions surrounding the optic nerve head, extending to the temporal arcades in an annular pattern. Fundus autofluorescence (FAF) revealed hypoautofluorescent areas corresponding to atrophic lesions, and Goldmann perimetry revealed ring scotomas consistent with lesions in the fundus. Swept-source optical coherence tomography revealed retinal pigment epithelium atrophy, loss of the choriocapillaris, and dilation of the choroidal medium and large vessels in the atrophic area. Full-field electroretinography revealed a mild reduction in the combined rod–cone response. Laser speckle flowgraphy revealed a cold color in the posterior pole of both eyes. Based on clinical and imaging findings, the patient was diagnosed with PPACD and followed up for 5 years. At the 5-year visit, visual acuity remained unchanged, while FAF and Goldmann perimetry revealed a slight enlargement of the atrophic lesions and scotoma in both eyes, respectively.

Conclusions and Importance

In the present case, atrophic lesions insidiously progressed and resulted in a slight enlargement of the hypoautofluorescent area and scotoma over a 5-year follow-up period, indicating that PPACD is a gradually progressive dystrophy.

Posterior polar annular choroidal dystrophy association with cystoid macular edema

Posterior polar annular choroidal dystrophy (PPACD) is an uncommon retinal dystrophy causing nyctalopia. PPACD has been characteristically described as a foveal sparing dystrophy. We report the first case with cystoid macular edema association.

Posterior polar annular and hemispheric choroidal and retinal dystrophy: Optical coherence tomographic angiography description of a rare case

Posterior polar annual choroidal dystrophy is a rare disease which affects the retina and choroid in an annular pattern. Our patient was referred to us a case of atypical retinitis pigmentosa. Fundus examination showed a normal optic disc, normal arterioles, and no bone spicules. The right eye showed a hemispheric pattern and the left eye showed an annular pattern of retinal and choroidal dystrophy. We describe the retinal and choroidal angiographic features of this case by optical coherence angiography.