A 35-year-old man consulted for sudden loss of central vision in his left eye. His personal history included having had a common cold for 10 days prior to the episode.
Clinical examination revealed an uncorrected visual acuity of 0.9 in the right eye and 0.1 in the left eye, with metamorphopsia in the latter. No inflammatory signs or anterior segment abnormalities were observed.
The left fundus showed macular thickening of approximately 2 papillary diameters (PD) with small intraretinal haemorrhages. The right fundus showed a yellowish-white lesion with a papillary diameter temporally inferior to the macula. Additional examinations included fluorescein angiography (FFA) and indocyanine green angiography (IGA), optical coherence tomography (OCT), B-mode ultrasound and a complete blood test.

The FFA of the IO shows a pattern of patchy hypofluorescence at very early times, followed by diffuse hyperfluorescence of the posterior pole with a better demarcated subfoveal hyperfluorescent area of 1 PD. AVI shows a hypofluorescent area with poorly demarcated borders in the posterior pole that is maintained with angiographic times.

OCT shows a loss of foveal thickness due to the existence of a subfoveal intraretinal cyst accompanied by small areas of perifoveal neurosensory retinal detachment (DRNS).

Both the ultrasound and the analytical study did not reveal any findings of interest.
Given this bilateral, albeit asymmetrical, yellowish-white lesion of inflammatory origin located in the chorioretinal interface, the probable diagnosis was acute posterior placoid epitheliopathy with an atypical presentation.
Due to the severe loss of VA, treatment was started with oral systemic corticosteroids administering 1mg/kg body weight of prednisone; a daily omeprazole tablet was also prescribed.
After 2 weeks, the patient came for a check-up and reported a very slight improvement in his LAA. The AVSC is 0.9 and 0.15 respectively. Fundus examination showed an increase in pigmentation of the lesions without any other signs of interest. The OCT shows alteration of the subfoveal RPE in the OI, with no evidence of the small perifoveal DRNS described above. The corticosteroid regimen was then tapered.

At 5 weeks the patient showed significant improvement with an AVSC of 0.9 in the OD and 0.6 in the OI. Fig. 5A shows the healing of the lesions corroborated by a control FFA.
At the last check-up performed one year after the onset of the episode, the patient's visual acuity recovered completely, with 0.9 in both eyes without correction. The fundus examination showed hyperpigmentation of the lesions corresponding to their scarring.