A 70-year-old Caucasian gentleman presented with decreased vision in the left eye and a subtle whitish macular plaque in the left eye and pigment mottling bilaterally. Indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCTA) revealed left macular hypoperfusion. Systemic evaluation was negative for infectious or inflammatory disorder. A diagnosis of persistent placoid maculopathy was made and systemic immunosuppression was initiated. A marked improvement in macular perfusion was noted on ICGA and OCTA following 1 week of immunosuppression, providing additional evidence of an inflammatory rather than ischemic etiology.
