Pigmentary epitheliopathy, disc edema, and lead intoxication.

A 52-year-old lead-exposed worker presented with disc edema, nerve fiber layer infarcts, and an acute bilateral pigment epitheliopathy that phenotypically resembled APMPPE. The patient had definite laboratory evidence of increased total body lead burden. The simultaneous involvement of retina, disc, and choriocapillaris suggests that what has been reported as the spectrum of APMPPE may represent a nonspecific vascular response to multiple injurious stimuli, including lead.