Abstract
A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes' best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA) showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF) was slightly increased. Spectral domain optical coherence tomography (SD-OCT) showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL). One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.
Highlights
Acute retinal pigment epitheliitis (ARPE), which is first described by Krill and Deutman [1], is a self-limiting disease of unknown aetiology typically affecting healthy young adults
The disease is characterized by acute onset of visual symptoms which resolve without treatment within 6 to 12 weeks [1,2,3,4]
We report Spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and fundus autofluorescence (FAF) findings of a patient diagnosed with ARPE
Summary
Acute retinal pigment epitheliitis (ARPE), which is first described by Krill and Deutman [1], is a self-limiting disease of unknown aetiology typically affecting healthy young adults. The diagnosis usually depends on symptoms and fundus examination findings. Spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) are ancillary tests which give us an understanding for the exact spatial location of the disrupted retinal layer. Fundus findings include small areas of fine pigment stippling surrounded by hypopigmented yellow-white haloes in the macular region [1,2,3,4,5,6,7,8,9]. We report SD-OCT, FA, and fundus autofluorescence (FAF) findings of a patient diagnosed with ARPE
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