An atypically distributed fleck case with multiple retinal pigment epithelial detachments

Abstract

A 45-year-old female patient presented with complaints of blurred vision and metamorphopsia with a duration of two months. Visual acuities were 0.1 in the right eye and 1.0 in the left eye. Fundus examination revealed bilateral, subretinal, round and yellow-white flecks with scattered localization in the fovea, macula and peripheral retina. Flecks were mostly concentrated in the macula and midperipheral fundus however were rare in the peripheral fundus. In fluorescein angiography, flecks were stained as well-demarcated hyperfluorescent lesions. In optical coherence tomography, there were hump-shaped lesions which have medium degree internal reflectivity at the level of retinal pigment epithelium along with hyporeflective dome-shaped pigment epithelial detachments. No genetic predisposition was found. As a consequence of these findings, the patient was diagnosed with an atypically distributed fleck case with multiple retinal pigment epithelial detachments