Punctate Inner Choroidopathy

Purpose. To report a case of bilateral punctate inner choroidopathy (PIC).Case Report. A 26-year-old Caucasian woman presented with bilateral blurred vision with one year of evolution. There was no relevant systemic disease or family history. Best-corrected visual acuity in the right eye was 20/30 and in the left eye was 20/20; there was no clinically significant refractive error. Fundoscopy evidenced multiple, small, round, yellow-white lesions limited to the posterior pole of both eyes, with greater macular involvement in the RE. There were no signs of inflammation in the anterior chamber or vitreous cavity. Fluorescein angiography revealed the presence of multiple hyperfluorescent lesions more evident in the later stages of the angiogram in both eyes. On indocyanine green angiography, these lesions appeared hypofluorescent in both early and late phases. Optical coherence tomography showed the presence of focal elevations of the retinal pigment epithelium with underlying hyporeflective space, bilaterally. Laboratory and imaging evaluation for evidence of autoimmune and infectious diseases were negative.Conclusion. The PIC is a relatively uncommon condition. In this report, an attempt has been made to describe a classic clinic presentation of this disease in a young and female patient.

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Central Serous Chorioretinopathy Induced by Work Stress: A Case Report

e-CliniC ◽

10.35790/ecl.v8i2.31107 ◽

2020 ◽

Vol 8 (2) ◽

Author(s):

Ade J. Nursalim ◽

Vera Sumual

Keyword(s):

Risk Factors ◽

Work Stress ◽

Central Serous Chorioretinopathy ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Blurred Vision ◽

Reading Text ◽

Neurosensory Retinal Detachment ◽

The Right

Abstrak: Central serous chorioretinopathy (CSC) adalah terkumpulnya cairan serosa di bawah lapisan epitel pigmen retina yang mengakibatkan terlepasnya retina neurosensorik (detachment). Keadaan ini dapat disebabkan oleh berbagai faktor risiko, termasuk stres psikologik. Jenis kelamin laki-laki merupakan salah satu faktor risiko CSC. Terapi kondisi psikologik merupakan pena-nganan utama CSC yang diinduksi oleh stres kerja. Kami melaporkan seorang laki-laki berusia 27 tahun yang datang ke Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Hospital dengan keluhan kekaburan mata kanan yang mendadak sejak seminggu lalu tanpa didahului oleh nyeri pada mata. Pasien juga mengalami kesulitan dalam membaca teks dan mengenali wajah bila hanya menggunakan mata kanannya. Pasien telah pergi ke optik tetapi tidak mendapatkan ukuran kacamata yang sesuai. Pasien bekerja sebagai tenaga administrasi dan akhir-akhir ini mendapatkan beban kerja berlebihan. Pasien mengakui bahwa ia mengalami kesulitan dalam mengatur aktivitasnya, dan merasakan kelelahan sepanjang hari serta kehilangan minat kerja. Hasil pemeriksaan mata mendapatkan visus 6/15 untuk mata kanan dan visus 6/6 untuk mata kiri, dan metamorphopsia sedangkan hasil pemeriksaan oftalmoskopi memperlihatkan adanya edema dengan lingkaran kekuningan dan berbatas tidak jelas pada mata kanan. Pemeriksaan lanjut dengan OCT menunjukkan adanya cairan subretinal pada mata kanan disertai terlepasnya lapisan epitel pigmen. Saat kontrol setelah 36 hari, visus mata kanan telah membaik 6/6F2 dan peme-riksaan OCT menunjukkan penurunan tebal makula dari 289 μm pada kunjugan pertama men-jadi 190 μm, serta tidak tampak adanya cairan subretinal. Simpulan kasus ini ialah central serous chorioretinopathy yang diinduksi oleh stres kerja, dengan penanganan utama ialah terapi psikologik untuk memperbaiki kualitas hidup.Kata kunci: central serous chorioretinopathy (CSC), stres kerja Abstract: Central serous chorioretinopathy (CSC) is a condition where serous fluid builds up in the retinal pigment epithelium layer which causes neurosensory retinal detachment. This condition is affected by many risk factors, including psychological stress. Male gender is one of the risk factors for CSC. Treatment to the patient's psychological condition can be the main therapy in handling CSC induced by work stress. We reported a 27-year-old male came to the eye clinic at Prof. dr. R. D. Kandou Hospital complaining of sudden blurred vision in his right eye a week ago without initial pain in the eye. The patient also experienced difficulty in reading text and recognizing people’s face using the right eye. The patient went to an optic store but he did not find suitable glasses. The patient works as an administrative employee and is currently getting a heavy workload at his workplace. The patient admitted that he had issues in managing his life in a day. Patients felt tired throughout the day and had no interest in making any activities. The results of the eye examination showed vision 6/15 in the right eye and 6/6 in the left eye, metamorphopsia, edema with a yellowish circle with an unclear border on the right eye using ophthalmoscopy examination, and a subretinal fluid image in the patient's right eye with epithelial detachment pigment acquired through the examination with OCT. After 36 days from the first visit, the right eye vision was improved to 6/6 F2 and OCT examination resulted in a decrease in macula thickness from 289 μm at the first visit to 190 μm, and there was no subretinal fluid. In conclusion, this was a CSC case induced by work stress, and the main treatment was psychological therapy in order to improve the quality of life (QoL).Keywords: central serous chorioretinopathy (CSC), work stress

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Drusen Formation in Type II Membranoproliferative Glomerulonephritis after Renal Transplantation

BANTAO Journal ◽

10.2478/bj-2014-0024 ◽

2014 ◽

Vol 12 (2) ◽

pp. 122-124

Author(s):

Marija Milinkovic ◽

Svetlana Jovicic-Pavlovic ◽

Milena Golubovic-Arsovska ◽

Radomir Naumovic

Keyword(s):

Membranoproliferative Glomerulonephritis ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Systemic Disease ◽

Posterior Pole ◽

Point Of View ◽

Type Ii ◽

Pigment Epithelial ◽

Allograft Function ◽

Cadaveric Transplantation

Abstract Type II membranoproliferative glomerulonephritis (MPGN) is a systemic disease that almost invariably recurs in renal allografts. This is a case of a 45-year-old woman with biopsy proven type II MPGN that led to renal failure 10 years after diagnosis. During the fifth month after cadaveric transplantation she was treated with pulse doses of methylprednisolone owing to acute T-cell mediated rejection without pathohistological signs of type II MPGN recurrence. One month later the patient was hospitalized due to acute bilateral vision deterioration. Ophthalmoscopy showed bilateral, multifocal drusen, concentrating in the posterior pole, and exudative ablation of the retinal pigment epithelium. Ocular coherence tomography (OCT) revealed focal retinal pigment epithelial elevation and detachments. The patient was treated with methylprednisolone (1 mg/kg) for 3 days. Therapy led to regression of exudation and flattening of the pigment epithelial detachments with discrete subjective visual improvement. Type II MPGN almost invariably recurs and leads to graft failure in 50% of cases. Our patient had evident chronic eye changes due to type II MPGN leaving allograft function intact during the first year of follow-up. Considering these potentially devastating effects of the disease, type II MPGN patients should be observed carefully from both the renal and eye point of view, because the severity of ocular changes, like in our case, is not always in line with allograft function.

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Ocular findings among patients surviving COVID-19

Scientific Reports ◽

10.1038/s41598-021-90482-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ílen Ferreira Costa ◽

Livia Pimenta Bonifácio ◽

Fernando Bellissimo-Rodrigues ◽

Eduardo Melani Rocha ◽

Rodrigo Jorge ◽

...

Keyword(s):

Visual Acuity ◽

Pigment Epithelium ◽

Demographic Data ◽

Retinal Pigment ◽

Anterior Segment ◽

Posterior Pole ◽

Architecture Evaluation ◽

Severe Group ◽

The Mean ◽

The Right

AbstractTo describe the medium-term ophthalmological findings in patients recovering from COVID-19. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. Socio-demographic data and personal medical history were also collected. According to the severity of systemic manifestations, patients were classified into mild-to-moderate, severe, and critical. Sixty-four patients (128 eyes) were evaluated 82 ± 36.4 days after the onset of COVID’s symptoms. The mean ± SD duration of hospitalization was 15.0 ± 10.7 days. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (0–0.2) and BCVA 0 (0–0.1). Anterior segment biomicroscopy was unremarkable, except for dry eye disease, verified in 10.9% of them. The mean ± SD intraocular pressure (IOP) in critical group (14.16 ± 1.88 mmHg) was significantly higher than in severe group (12.51 ± 2.40 mmHg), both in the right (p 0.02) and left eyes (p 0.038). Among all, 15.6% had diabetic retinopathy, and two patients presented with discrete white-yellowish dots in the posterior pole, leading to hyporreflective changes at retinal pigment epithelium level, outer segment, and ellipsoid layers. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. No sign of uveitis was found.

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An atypically distributed fleck case with multiple retinal pigment epithelial detachments

Advances in Ophthalmology & Visual System ◽

10.15406/aovs.2021.11.00399 ◽

2021 ◽

Vol 11 (1) ◽

pp. 1-3

Author(s):

Sercan Cate ◽

Caglar Bektas ◽

Burak Turgut

Keyword(s):

Optical Coherence Tomography ◽

Retinal Pigment Epithelial ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Peripheral Retina ◽

Fundus Examination ◽

Blurred Vision ◽

Pigment Epithelial ◽

The Right ◽

Internal Reflectivity

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

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Okuläre Symptome nach COVID-19-Infektion

Karger Kompass Ophthalmologie ◽

10.1159/000520267 ◽

2021 ◽

pp. 1-3

Author(s):

Katja Göbel

Keyword(s):

Visual Acuity ◽

Pigment Epithelium ◽

Demographic Data ◽

Retinal Pigment ◽

Anterior Segment ◽

Posterior Pole ◽

Architecture Evaluation ◽

Severe Group ◽

The Mean ◽

The Right

To describe the medium-term ophthalmological findings in patients recovering from COVID-19. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. Socio-demographic data and personal medical history were also collected. According to the severity of systemic manifestations, patients were classified into mild-to-moderate, severe, and critical. Sixty-four patients (128 eyes) were evaluated 82 ± 36.4 days after the onset of COVID’s symptoms. The mean ± SD duration of hospitalization was 15.0 ± 10.7 days. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (0–0.2) and BCVA 0 (0–0.1). Anterior segment biomicroscopy was unremarkable, except for dry eye disease, verified in 10.9% of them. The mean ± SD intraocular pressure (IOP) in critical group (14.16 ± 1.88 mmHg) was significantly higher than in severe group (12.51 ± 2.40 mmHg), both in the right (p 0.02) and left eyes (p 0.038). Among all, 15.6% had diabetic retinopathy, and two patients presented with discrete white-yellowish dots in the posterior pole, leading to hyporreflective changes at retinal pigment epithelium level, outer segment, and ellipsoid layers. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. No sign of uveitis was found.

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Choroidal Neovascularization Associated with Punctate Inner Choroidopathy: Combination of Intravitreal Anti-VEGF and Systemic Immunosuppressive Therapy

Case Reports in Ophthalmology ◽

10.1159/000441694 ◽

2015 ◽

Vol 6 (3) ◽

pp. 385-389 ◽

Cited By ~ 6

Author(s):

Bettina Hohberger ◽

Michael Rudolph ◽

Antonio Bergua

Keyword(s):

Visual Acuity ◽

Choroidal Neovascularization ◽

Combined Therapy ◽

Retinal Pigment ◽

Posterior Pole ◽

Prednisolone Acetate ◽

Eye Drops ◽

Punctate Inner Choroidopathy ◽

Anti Vegf ◽

Systemic Medication

Purpose: Choroidal neovascularization (CNV) associated with punctate inner choroidopathy (PIC) is a rare clinical entity, yet still a challenge for medical treatment. A case of a young myopic woman developing CNV secondary to unilateral PIC is presented. Clinical morphology, diagnostic procedure and follow-up are reported. Case Report: A 29-year-old woman presented with multiple yellowish dots at the posterior pole. No other signs of inflammation could be seen. Angiography with fluorescein yielded hyperfluorescent signals in the affected areas with a diffuse leak, and SD-OCT showed a slightly elevated retinal pigment epithelial layer, consistent with the diagnosis of PIC. Additionally a classic CNV was observed. Results: Anti-inflammatory therapy with local prednisolone acetate eye drops in combination with intravitreal injection of anti-vascular endothelial growth factor (VEGF, bevacizumab) yielded an increased best-corrected visual acuity. As CNV reappeared, systemic medication with prednisone and azathioprine in combination with two further intravitreal injections of anti-VEGF stabilized CNV and increased visual acuity again. Conclusion: Combined therapy of immunosuppression with intravitreal anti-VEGF injections can be considered as therapeutic strategy in the management of recurrent CNV associated with PIC.

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Focal Choroidal Excavation in a Case of Choroidal Osteoma Associated with Choroidal Neovascularization

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v15i3.7461 ◽

2020 ◽

Author(s):

Mahdieh Azimizadeh ◽

Seyedeh Maryam Hosseini ◽

Esmaeil Babaei

Keyword(s):

Choroidal Neovascularization ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Retinal Hemorrhage ◽

Retinal Layers ◽

Choroidal Osteoma ◽

Focal Choroidal Excavation ◽

Neurosensory Retina ◽

The Right

Purpose: To report a case of choroidal osteoma associated with reactivation of choroidal neovascularization (CNV) and development of focal choroidal excavation (FCE). Case Report: A 34-year-old woman with choroidal osteoma complicated by CNV in the right eye for two years presented with deterioration of visual acuity in her right eye. A small retinal hemorrhage accompanied by subretinal fluid (SRF) was seen in the macular area of the right eye. Optical coherence tomography (OCT) showed that the inner retina was intact, and the outer retinal layers had outward displacement. SRF and a wedge-shaped choroidal depression were also seen. This choroidal excavation was not present on previous OCT images. The integrity of the inner retinal layers was maintained, and an optically clear space was present between the neurosensory retina and the retinal pigment epithelium. Conclusion: Choroidal osteoma can be complicated by CNV and FCE could occur as a consequence. Again, FCE can lead to CNV development. This cascade can deteriorate vision and sometime lead to permanent visual loss.

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Multimodal imaging evaluation of combined hamartoma of the retina and retinal pigment epithelium

European Journal of Ophthalmology ◽

10.1177/1120672119831223 ◽

2019 ◽

Vol 30 (3) ◽

pp. 595-599 ◽

Cited By ~ 1

Author(s):

Andrea Scupola ◽

Gabriela Grimaldi ◽

Maria G Sammarco ◽

Paola Sasso ◽

Michele Marullo ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Retinal Pigment Epithelium ◽

Multimodal Imaging ◽

Optical Coherence Tomography Angiography ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Case Series ◽

Variable Degree ◽

Optical Coherence ◽

Imaging Evaluation

Purpose: Combined hamartoma of the retina and retinal pigment epithelium is a rare benign tumor characterized by a variable combination of glial, vascular, and pigmented components. The purpose of our study was to analyze the features of combined hamartoma of the retina and retinal pigment epithelium on optical coherence tomography angiography. Methods: Small case series of two cases of combined hamartoma of the retina and retinal pigment epithelium with macular and optic nerve involvement, evaluated with multimodal imaging including optical coherence tomography, fluorescein angiography, and optical coherence tomography angiography. Results: On optical coherence tomography, combined hamartoma of the retina and retinal pigment epithelium is characterized by disruption of the inner neurosensory retina and a variable degree of involvement of the external retina. Optical coherence tomography angiography showed diffuse alterations of the retinal vessels of the superficial and deeper layers, extended to the peripapillary area. Vessel abnormalities included increased tortuosity and caliber of vessels, vascular traction, and vessel stretching within the lesion. Conclusion: Optical coherence tomography angiography allows in-depth multilayer analysis of tumor vascular network, highlighting the fine abnormalities of retinal vasculature characteristic of combined hamartoma of the retina and retinal pigment epithelium.

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Acquired retinoschisis and vitreous hemorrhage as unusual findings in choroideremia: Case report

European Journal of Ophthalmology ◽

10.1177/1120672120946576 ◽

2020 ◽

pp. 112067212094657

Author(s):

Dario Pasquale Mucciolo ◽

Vittoria Murro ◽

Dario Giorgio ◽

Andrea Sodi ◽

Ilaria Passerini ◽

...

Keyword(s):

Case Report ◽

Retinal Pigment Epithelium ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Vitreous Hemorrhage ◽

Advanced Stage ◽

Vascular Abnormalities ◽

Diagnostic Difficulties ◽

The Right

Purpose: To report a case of choroideremia characterized by peripheral retinoschisis with vascular abnormalities and vitreous hemorrhage. Observations: A 58-year-old man affected by advanced-stage choroideremia was diagnosed with peripheral retinoschisis in both eyes. Vitreous hemorrhage was present in the right eye with a peculiar clot-like lesion at the periphery. At the 1-year follow-up, the vitreous hemorrhage had reabsorbed and the vascular clot-like lesion in the periphery had almost completely disappeared. Conclusion and importance: We have reported fundoscopic and OCT features of peripheral-acquired retinoschisis with vascular abnormalities in a patient with choroideremia. OCT examination is extremely useful in clinical evaluation of the peripheral retinal alterations in these cases, where the absence of the retinal pigment epithelium and the choriocapillaris pose many diagnostic difficulties.

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A PRPH2 gene variant detected in retinitis punctata albescens with congenital hypertrophy of the retinal pigment epithelium

European Journal of Ophthalmology ◽

10.1177/1120672120962027 ◽

2020 ◽

pp. 112067212096202

Author(s):

Aowang Qiu ◽

Yan Yu ◽

Junlong Huang ◽

Qinghuai Liu ◽

Yannis M Paulus ◽

...

Keyword(s):

Retinal Pigment Epithelium ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Cone Photoreceptor ◽

Blurred Vision ◽

Full Field ◽

Photoreceptor Outer Segments ◽

Pigmented Lesions ◽

Retinitis Punctata Albescens ◽

Congenital Hypertrophy

Retinitis punctata albescens (RPA) is generally diagnosed by the presence of numerous clusters of white punctate lesions in the retina that progress over time and are related to several gene variants. The multifocal variant of congenital hypertrophy of the retinal pigment epithelium (CHRPE) is characterized by multiple, grouped, sharply circumscribed, pigmented spots. The PRPH2 gene encodes a photoreceptor-specific glycoprotein, which is essential for the morphogenesis of rod and cone photoreceptor outer segments. A 39-year-old Chinese female with nyctalopia, complained about blurred vision, presented a unique co-existing feature of RPA and CHRPE. Dilated fundus exam demonstrated numerous porcelain white discrete dots in both eyes and multiple, small, flat clusters of round brown to black pigmented lesions in the left eye. The full field electroretinography (ERG) showed decreased responses after standard dark adaptation and normal b-wave amplitudes after a long (4-h) dark-adapted period. A heterozygous PRPH2 splicing variant was detected in the proband. In addition, the same variant was found in her mother, her son, and her daughter. We describe a PRPH2 variant in a rare case of RPA associated with multifocal CHRPE of the same individual.

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