Abstract
Background and Objectives: Pigmented paravenous retinochoroidal atrophy (PPRCA) is a rare disease with bilateral retinal pigment epithelium and choroidal atrophy. We present a case of PPRCA using multimodal imaging studies. Case summary: A 61-year-old female was referred to our department for floaters. Funduscopic examination revealed pigment clumps and grayish lesions along the retinal vein and the peripheral area, bilaterally. She did not have nyctalopia or any other visual symptoms including visual loss. She was diagnosed with pigmented paravenous retinochoroidal atrophy based on the typical findings of fundus. The findings of wide fluorescein angiography (FA), wide indocyanine green angiography (ICGA), fundus autofluorescence (FAF), spectral domain-optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCTA), the visual field (VF) and an electroretinogram (ERG) could help us to confirm the diagnosis. The patient did not have any specific treatment for PPRCA in our study and there was no change in visual acuity and multimodal imaging of both eyes over one year. Conclusions: We report a case of PPRCA and the multimodal imaging of this patient. PPRCA is very rare disease and sometimes it is easy to get confused with other diseases such as retinitis pigmentosa and vasculitis when it comes to diagnosis. Multimodal imaging features of PPRCA will improve our understanding, diagnosis and prediction of the prognosis of this disease.
Highlights
Pigmented paravenous retinochoroidal atrophy (PPRCA) is an uncommon disease with unknown etiology characterized by retinochoroidal atrophy and pigment clumping distributed along the retinal veins, usually occurring in a bilateral and symmetric fashion [1]
We investigated the imagery diagnostic and typical features of ultra-wide field fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA), wide-field fundus autofluorescence, optical coherence tomography, optical coherence tomography angiography (OCTA), the visual field and electrophysiological assessment
Wide-field fundus autofluorescence showed increased fluorescence with a crescent-like distribution surrounding the area of retinal pigment epithelium (RPE) atrophy along the retinal vein and a decreased fluorescence pattern spreading in a fin shape into the peripheral area, bilaterally
Summary
Pigmented paravenous retinochoroidal atrophy (PPRCA) is an uncommon disease with unknown etiology characterized by retinochoroidal atrophy and pigment clumping distributed along the retinal veins, usually occurring in a bilateral and symmetric fashion [1]. It is usually asymptomatic and often diagnosed fortuitously during routine fundus examination, as the disease tends to be non-progressive or slowly progressive [2]. We investigated the imagery diagnostic and typical features of ultra-wide field fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA), wide-field fundus autofluorescence, optical coherence tomography, optical coherence tomography angiography (OCTA), the visual field and electrophysiological assessment. The patient has provided informed consent for publication of the case
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