I am seeing a repeatable issue. When first inserting a PNG file generated by PlantUML into a confluence page, it appears to display the image correctly. After publishing the page, the image still appears correctly, but after refreshing/reloading the page, a gray box is shown with the message "Preview unavailable".
After trying a number of different things with PNG files, the issue is related to either a `tEXT` or `iTXt` chunk in the PNG file. PlantUML inserts a `tEXt` chunk in the PNG file with the string: "keyword: copyleft Generated by http://plantuml.com"
And the `iTXt` chunk contains the PlantUML source for the generated diagram.
If you remove these chunks by adding the command line option `-nometadata` to plantuml, the resulting PNG does not contain these chunks and Confluence seems to display it correctly.