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H. Naacke, S. Sheer, C. Laurens, J. Sahel; Acute retinal pigment epitheliitis: new clinical and angiographic aspects. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5159.
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Purpose:We report a case with a typical history of the disease, but with unusual marked clinical and angiographic findings in the acute phase. Methods:A 27–years–old man developed sudden central scotoma of the right eye. His ocular and medical history were non contributive. On initial examination, best corrected visual acuity was 0.1 for the right eye and 1.0 for the left eye. Ocular examination was normal, except a migration and accumulation of clods of pigment in the right macula. Fluorescein angiography revealed annular hyperfluorescent confluent flecks, without leakage. A multifocal electroretinogram confirmed a right maculopathy, and color vision showed a yellow–green axis. The left eye exam was normal. One week later, visual acuity improved in the right eye (0.3) and ocular examination was unchanged. Ocular coherence tomography was realised one month after the onset of the disease and was normal. The patient could be examined again only four months later. Right visual acuity was 1.0. The aspect of the right macula was different, with delicate pigmentation surrounded by whitish halos, which are typical lesions of an acute retinal pigment epitheliitis. Angiographic findings showed lacy hyperfluorescence without leakage, probably corresponding to windows defects in the halo–like areas . Results: Thus the diagnosis of acute retinal pigment epitheliitis was confirmed. Conclusions: Acute retinal pigment epitheliitis is a rare self–limited macular disorder affecting young adults. This disease causes a transient unilateral scotoma associated with a classic and characteristic delicate pigmentary change in the macula.
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