Posterior scleritis and acute posterior multifocal placoid pigment epitheliopathy: A case of painful chorioretinitis and review of the current literature

Purpose

To describe a patient who developed concurrent acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and posterior scleritis.

Observations

We describe a middle-aged woman that developed eye pain and photopsia. She was found to have a “T-sign” on ultrasound of the right eye and multiple, nearly confluent, ill-defined subretinal whitish lesions in both eyes. After an extensive laboratory evaluation and neuroimaging, her photopsia, pain with eye movements, and subretinal lesions began to regress on high dose systemic corticosteroids.

Conclusions and Importance

This is the first reported case of bilateral APMPPE and concurrent posterior scleritis. Our case highlights the importance of performing a full review of systems, specifically eliciting neurological changes, and dilated eye examination in all new uveitis cases.

Prenatally diagnosed monochorionic diamniotic triplet pregnancy

We present an extremely rare case of monochorionic diamniotic (MD) triplet pregnancy diagnosed via ultrasonography at the end of the first trimester that resulted in delivery of three healthy newborns. Ultrasonography for a 34-year-old woman at 12 weeks of gestation showed three fetuses and one placenta with a T-sign at the initial segment of the dividing membrane. Color Doppler examination revealed umbilical cord entanglement between two fetuses in one sac in addition to another sac containing one fetus. Therefore, this was diagnosed as MD triplet pregnancy. The triplets were delivered by cesarean section at 35 weeks of gestation and were healthy without neurological morbidities at the age of 28 days. Histopathological examination also revealed an MD triplet placenta. The possibility of MD triplet pregnancy should be recognized, although it is rare.