Persistent Placoid Maculopathy: Long-term Outcomes and Prognostic Factors

Seppey C, Kaisari E, Anjou M, Eandi CM, Ambresin A, Brézin AP, Guex-Crosier Y, Hoogewoud F

Retina. 2026 Oct 1;46(10):1740-1747. doi: 10.1097/IAE.0000000000004914.

Summary

Persistent placoid maculopathy: Final VA worse than 20-100 in one-third of eyes; MNV in 65%; Systemic cardiovascular comorbidities in 88%; Disease reactivation common — Retrospective, at least 23-month FU, 23 patients

Abstract

Purpose: To evaluate the long-term visual outcomes, recurrence, complication rate, and systemic associations of persistent placoid maculopathy. We also aimed to identify predictors of final visual acuity.

Methods: This study combined a retrospective multicenter case series from three tertiary referral centers with a systematic review of the literature. Inclusion criteria were bilateral placoid macular lesions with characteristic multimodal imaging findings and a minimum follow-up of 23 months. Visual acuity, systemic associations, complications, recurrence, and treatments were assessed.

Results: Twenty-three patients (46 eyes) were included, six patients from our centers and 17 patients from the literature. The median follow-up was 3.75 years. Severe visual loss (<20/100) at final follow-up was observed in one third of eyes. Choroidal neovascularization occurred in 65.2% of eyes and recurrence in 21.7%. Systemic cardiovascular comorbidities were common (87.5%), and two patients presented cerebral vasculitis. Systemic treatment was significantly associated with better final visual acuity ( P = 0.014).

Conclusion: Persistent placoid maculopathy presents a high complication rate and poor visual prognosis. Systemic treatment was significantly associated with better final visual acuity in our study.