A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis

Nathalie Puche1, Olivier Offret1, Jean-Antoine Bernard1, Francine Behar-Cohen1,21Department of Ophthalmology, Hotel Dieu de Paris, AP-HP, Universit&eacute; Paris Descartes; 2Inserm UMRS872, Physiopathology of Ocular Diseases: Therapeutic Innovations, Centre de Recherche des Cordeliers, Unive...

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Autores principales:	Nathalie Puche, Olivier Offret, Jean-Antoine Bernard, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/33b3c46758df42eab7cab2028cd5bc44
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spelling	oai:doaj.org-article:33b3c46758df42eab7cab2028cd5bc442021-12-02T07:54:12ZA case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis1177-54671177-5483https://doaj.org/article/33b3c46758df42eab7cab2028cd5bc442010-09-01T00:00:00Zhttp://www.dovepress.com/a-case-of-acute-retinal-pigment-epithelitis-spectral-domain-optical-co-a5296https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Nathalie Puche1, Olivier Offret1, Jean-Antoine Bernard1, Francine Behar-Cohen1,21Department of Ophthalmology, Hotel Dieu de Paris, AP-HP, Universit&eacute; Paris Descartes; 2Inserm UMRS872, Physiopathology of Ocular Diseases: Therapeutic Innovations, Centre de Recherche des Cordeliers, Universit&eacute; Paris Descartes, Paris, FrancePurpose: To report the time course of retinal morphologic changes in a patient with acute retinal pigment epithelitis (ARPE) using spectral domain optical coherence tomography (SD-OCT).Methods: A 30-year old man was referred for blurred vision of his right eye after five days that appeared suddenly 15 days after recovery from a flu-like syndrome. SD-OCT was performed immediately, followed by fluorescein and infracyanine angiography at eight days and then at three weeks.Results: At presentation, a bubble of sub-macular deposit was observed on the right macula with central golden micronodules in a honeycomb pattern. SD-OCT showed an &ldquo;anterior dislocation&rdquo; of all the retinal layers up to the inner/outer segment (IS/OS) line and irregular deposits at the OS level together with thickening of the retinal pigment epithelial (RPE) layer. As visual acuity increased, eight days later, the OCT showed reduction of the sub-retinal deposits and an abnormal hyperflectivity of the sub-retinal and RPE layers was observed. The patient showed a positive serology for picornavirus.Discussion: The acute SD-OCT sections of this patient with ARPE were compared with histological sections of a 35 day old Royal College of Surgeons rat. Similar findings could be observed, with preservation of the IS/OS line and accumulation of debris at the OS level, suggesting that ARPE symptoms could result from a transient phagocytic dysfunction of the RPE at the fovea, inducing reversible accumulation of undigested OS. Picornaviruses comprising enterovirus and coxsachievirus described as being associated with acute chorioretinitis. In this case, it was responsible for ARPE.Conclusion: We hypothesize that ARPE syndrome results from a transient dysfunction of RPE, which can occur as a post viral reaction.Keywords: acute retinal pigment epithelitis, picornavirus, SD-OCT Nathalie PucheOlivier OffretJean-Antoine Bernardet alDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 1029-1033 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Nathalie Puche Olivier Offret Jean-Antoine Bernard et al A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis
description	Nathalie Puche1, Olivier Offret1, Jean-Antoine Bernard1, Francine Behar-Cohen1,21Department of Ophthalmology, Hotel Dieu de Paris, AP-HP, Universit&eacute; Paris Descartes; 2Inserm UMRS872, Physiopathology of Ocular Diseases: Therapeutic Innovations, Centre de Recherche des Cordeliers, Universit&eacute; Paris Descartes, Paris, FrancePurpose: To report the time course of retinal morphologic changes in a patient with acute retinal pigment epithelitis (ARPE) using spectral domain optical coherence tomography (SD-OCT).Methods: A 30-year old man was referred for blurred vision of his right eye after five days that appeared suddenly 15 days after recovery from a flu-like syndrome. SD-OCT was performed immediately, followed by fluorescein and infracyanine angiography at eight days and then at three weeks.Results: At presentation, a bubble of sub-macular deposit was observed on the right macula with central golden micronodules in a honeycomb pattern. SD-OCT showed an &ldquo;anterior dislocation&rdquo; of all the retinal layers up to the inner/outer segment (IS/OS) line and irregular deposits at the OS level together with thickening of the retinal pigment epithelial (RPE) layer. As visual acuity increased, eight days later, the OCT showed reduction of the sub-retinal deposits and an abnormal hyperflectivity of the sub-retinal and RPE layers was observed. The patient showed a positive serology for picornavirus.Discussion: The acute SD-OCT sections of this patient with ARPE were compared with histological sections of a 35 day old Royal College of Surgeons rat. Similar findings could be observed, with preservation of the IS/OS line and accumulation of debris at the OS level, suggesting that ARPE symptoms could result from a transient phagocytic dysfunction of the RPE at the fovea, inducing reversible accumulation of undigested OS. Picornaviruses comprising enterovirus and coxsachievirus described as being associated with acute chorioretinitis. In this case, it was responsible for ARPE.Conclusion: We hypothesize that ARPE syndrome results from a transient dysfunction of RPE, which can occur as a post viral reaction.Keywords: acute retinal pigment epithelitis, picornavirus, SD-OCT
format	article
author	Nathalie Puche Olivier Offret Jean-Antoine Bernard et al
author_facet	Nathalie Puche Olivier Offret Jean-Antoine Bernard et al
author_sort	Nathalie Puche
title	A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis
title_short	A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis
title_full	A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis
title_fullStr	A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis
title_full_unstemmed	A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis
title_sort	case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/33b3c46758df42eab7cab2028cd5bc44
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A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis

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