Evaluating an Algorithm for Prescribing Mildly Thick Liquids as a Temporary Bridge to an Oral Diet in the Acutely Hospitalized Population.

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE), a form of White Dot Syndrome, was initially identified by Gass in 1968 as an inflammatory chorioretinopathy that predominantly affects healthy young adults and typically follows a benign, self-limiting course []. Clinically, it is characterized by the sudden onset of bilateral visual symptoms and multiple placoid lesions at the posterior pole. While its classic presentation is well described, atypical features such as multiple serous retinal detachments (SRDs) and bacillary layer detachments (BALADs) are rarely observed. They may cause considerable diagnostic confusion, particularly in conditions such as Vogt-Koyanagi-Harada (VKH) syndrome []. We report a diagnostically challenging case of APMPPE in a young female who presented with bilateral SRD and BALAD, findings more typically associated with VKH. This case underscores the importance of recognizing uncommon manifestations of APMPPE and integrating multimodal imaging and systemic clues to avoid misdiagnosis and overtreatment. An 18-year-old Asian Indian girl presented with a sudden onset of painless diminution of vision in both eyes, accompanied by metamorphopsia for the past three days. There was no history of fever, tinnitus, or other viral prodromal symptoms. On examination, the best-corrected visual acuity (BCVA) was 20/40 in both eyes. Intraocular pressures were within normal limits. Anterior segment examination was unremarkable in both eyes. Posterior segment evaluation revealed mild vitritis and multiple SRD confined to the posterior pole in both eyes. Additionally, multiple yellowish placoid lesions were noted at the posterior pole, varying in size from approximately one-fourth disc diameter to one disc diameter (). Based on these findings, a differential diagnosis of VKH syndrome and APMPPE was considered.