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Retinal pigmentary changes in chronic uveitis mimicking retinitis pigmentosa

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PurposeTo present retinal pigmentary changes mimicking retinitis pigmentosa (RP) as a finding of advanced uveitis.MethodsWe retrospectively reviewed charts of patients without a family history of inherited retinal degenerations who presented… Click to show full abstract

PurposeTo present retinal pigmentary changes mimicking retinitis pigmentosa (RP) as a finding of advanced uveitis.MethodsWe retrospectively reviewed charts of patients without a family history of inherited retinal degenerations who presented with retinal pigment changes and signs of past or present intraocular inflammation. Comprehensive eye examination including best-corrected visual acuity, slit-lamp examination and dilated fundus examination was performed on all patients in addition to color fundus photography, optical coherence tomography, fluorescein angiography (FA), and full-field electroretinogram testing.ResultsWe identified five patients with ages ranging from 33 to 66 years, who presented with RP-like retinal pigmentary changes which were eventually attributed to longstanding uveitis. The changes were bilateral in three cases and unilateral in two cases. Four of five cases presented with active inflammation, and the remaining case showed evidence of active intraocular inflammation during follow-up.ConclusionThis study highlights the overlapping features of advanced uveitis and RP including the extensive pigmentary changes. Careful review of possible past uveitis history, detailed examination of signs of past or present inflammation and ancillary testing, with FA often being most helpful, are required for the correct diagnosis. This is important, because intervention can prevent further damage if the cause of the pigmentary changes is destructive inflammation.

Keywords: inflammation; mimicking retinitis; pigmentary changes; retinitis pigmentosa; uveitis; retinal pigmentary

Journal Title: Graefe's Archive for Clinical and Experimental Ophthalmology
Year Published: 2017

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