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Acute Retinal Pigment Epithelitis

Acute Retinal Pigment Epithelitis. Dr. Dipankar Das, MS Dr. Rachana Jain, DO, DNB Dr.Harsha Bhattacharjee, MS Sri Sankaradeva Nethralaya, Guwahati, Assam, INDIA. Ocular History. 22 year old lady 2-2007: OD blurred vision. March 2007: First Presentation. VA: OD 20/20, OS 20/20

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Acute Retinal Pigment Epithelitis

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  1. Acute Retinal Pigment Epithelitis Dr. Dipankar Das, MS Dr. Rachana Jain, DO, DNB Dr.Harsha Bhattacharjee, MS Sri Sankaradeva Nethralaya, Guwahati, Assam, INDIA

  2. Ocular History • 22 year old lady • 2-2007: OD blurred vision

  3. March 2007: First Presentation • VA: OD 20/20, OS 20/20 • No AC, vitreous reaction • Fundus: • Resolved Multifocal choroiditis OD

  4. March 2007: First Presentation • CBC, Chest X Ray, CT Scan Brain and orbit –Normal,VDRL-Non reactive, Mantoux test 9mm induration, FFA Resolving lesions • Kept under observation • Improvement

  5. After 14 days March 2007 • OS Blurred vision • VA OD 20/20, OS 20/20 • No reaction in AC & vitreous • Fundus OS Creamish subretinal lesion with few hyperpigmented dark grey areas surrounded by yellowish white halo. • FFA, hypoflourescence surrounded by hyperflourescence in active lesions

  6. After 14 days March 2007 • ERG- Normal • EOG- Subnormal Left eye • CBC, Mantoux, VDRL, CX Ray - Normal • Observation

  7. April 2007 • VA 20/20 OD, 20/20 OS • Resolving lesion left eye

  8. May 2007 • OD: 20/20, OS: 20/20 • Healed lesion OS

  9. EOG (last follow-up)-OU WNL

  10. Final Diagnosis • Acute Retinal Pigment Epithelitis • Atypical clinical manifestation immitating • MEWDS • Acute Macular Neuroretinopathy • Acute posterior multifocal placoid pigment epitheliopathy • Central serous chorioretinopathy • Rubella retinitis • No treatment required

  11. Problems • Rare • New Clinical Entity • Subtle fundus changes that can be missed, if not kept in mind.

  12. Conclusion • Acute retinal pigment epithelitis or Krill’s disease is a rare, yet relatively new clinical entity (1972) • Characterised by Acute inflammation of the retinal pigment epithelium and manifested by transient and subtle alteration at the level of the RPE • Needs no treatment, remission and recurrences noted with good visual prognosis

  13. Thank you

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