Seven-year evaluation of idiopathic multiple retinal pigment epithelium detachments

Objective: To analyze a 7-year natural history of idiopathic multiple retinal pigment epithelium (RPE) detachment based on optical coherence tomography (OCT) images. Methods: Case report. SD-OCT imaging (Topcon 3D OCT-1000). Results: A 55-year-old female presented with three foci of pigment epithelium detachment (PED) in her left eye. Her past ophthalmic and medical history was uneventful. The patient's visual acuity in both eyes was 1.0 throughout the follow-up period. Fluorescein angiography images are shown. Corresponding OCT scans illustrate natural history of the PED foci and retinal structure of the left eye. PED number, location, shape, size and morphology were analyzed. Initially, the dimensions of PEDs were stable, but then a tendency to fluctuate or flatten was observed. Eventually, the lesions have resolved completely. Apart from the detachments, no other structural abnormalities of the retina were found. No PEDs, but sub-, para- and perifoveal RPE protrusions and defects were detected in the right eye. Conclusions: In the hereby presented case: 1. OCT proved to be suitable for diagnosis and monitoring of multiple PEDs. 2. Multiple idiopathic PEDs without involvement of the fovea were asymptomatic and regressed spontaneously. As such, they did not require any treatment. However, they were monitored due to potential risk for choroidal neovascularization or serous retinal detachment.