Bacillary Layer Detachment in Hyper-acute Stage of Acute Posterior Multifocal Placoid Pigment Epitheliopathy: A Case Series

Background: The term bacillary layer detachment (BLD) represents a possible separation between the myoid and ellipsoid component of the inner segment, following insult or injury to the outer retina. It has been described previously in cases of toxoplasma retinochoroiditis, central serous chorioretinopathy, Vogt Koyanagi Harada disease and trauma. Purpose: To describe the presence of BLD in Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE). Method: Clinical and OCT-based description of three consecutive cases of APMPPE with BLD. Result: All the three cases (a 25-year-old female, a 36-year-old male, and a 32-year-old male) presented with unilateral, diminution of vision of acute onset. They were diagnosed as APMPPE and OCT revealed a splitting of the ellipsoid zone, resembling a BLD. All the three cases showed complete resolution by 1 week. Conclusion: BLD appears in the acute stage of APMPPE and resolves rapidly within a week.