Clinical features of acute retinal pigment epitheltis

AIM: To analyze of the clinical features of acute retinal pigment epitheltis(ARPE). <p>METHODS: The clinical data of 36 ARPE patients(40 eyes)attending this center from January 2008 to January 2014 were reviewed retrospectively. Of them, 21 patients(58.3%)were male(male:female=1:0.71). The mean age was 40.92±7.13 years old(range:17～60y). The mean best-corrected visual acuity(BCVA)was 0.50±0.26 with a range of 0.3～1.0. Thirty-two patients were unilateral cases. All the patients were examined for BCVA, funds photography, fluorescein fundus angiography(FFA), optical coherence tomography(OCT). FFA was shown as three types: type Ⅰ to multiple "black light" or "grape variety" fluorescent spot; Type Ⅱ for I lesions visible fluorescence leakage; Type Ⅲ lesions with choroid neovascularization(CNV). OCT was the following three forms: multiple RPE lesions layer reflection intermittent, proliferation(type Ⅰ); pigment epithelial detachment with limitations neural epithelium(type Ⅱ); types I and II with CNV(type Ⅲ).<p>RESULTS: Ocular fundus showed that the lesions were multiple dark-gray spots with a dark circumscribed area at the macular or nearby in all 40 eyes. FFA showed: 21 eyes were type Ⅰ, 17 eyes were type Ⅱ and 2 eyes were type Ⅲ, BCVA between type Ⅰ and type Ⅱ was statistically significant(<i>P</i><0.05), the same was between type Ⅲ. BCVA between different cases in the same type and between type Ⅱ, Ⅲ, was no statistical difference(<i>P</i>>0.05). OCT showed 21 eyes wwere type Ⅰ, 17 eyes were type Ⅱ and type Ⅲ 2 eyes. BCVA average between type Ⅰ and Ⅱ was statistically significant(<i>P</i><0.05). The mean BCVA was no statistically significant difference between type Ⅱ and Ⅲ patients(<i>P</i>>0.05).<p>CONCLUSION: ARPE fundus demonstrated the multiple dark gray discrete lesions, the degree of visual impairment related with the presence of pigment epithelial barrier and lesion location. OCT and FFA characterized three types. FFA is shown as "black light" or "grape variety" fluorescent spot, and is the basis of diagnosis. OCT can display the lesions organization form of each layer clearly. It plays a more and more important role in the diagnosis and differential diagnosis of ARPE