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Pigment epithelium detachment with thickened choroid in a preterm infant at term-equivalent age: a case report
Seong Joon Ahn1,2, Vincent Tai1, Katrina P Winter1
1Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States.
Insights
Pigment epithelial detachment (PED) in neonates is rare. This case suggests inhaled steroids may cause temporary PED and choroidal thickening in preterm infants, resolving after treatment stops.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Pigment epithelial detachment (PED) is typically seen in adult retinal diseases.
- PED is rarely reported in the neonatal population, particularly in preterm infants.
Observation:
- A preterm infant (31 weeks gestation) developed PED with choroidal thickening at term-equivalent age.
- This occurred around 39 weeks postmenstrual age, coinciding with inhaled corticosteroid therapy for respiratory distress.
Findings:
- Handheld optical coherence tomography (OCT) detected the PED and choroidal changes.
- The PED resolved by 41 weeks postmenstrual age after discontinuation of inhaled steroids, with no lasting structural damage.
Implications:
- This case suggests a potential association between inhaled steroid use and transient PED with choroidal changes in preterm neonates.
- It highlights the utility of OCT in diagnosing retinal and choroidal abnormalities in preterm infants.
- It underscores the impact of medications on the neonatal choroid.
Abstract:
Pigment epithelial detachment (PED) is well-documented in adult retinal diseases but is rarely reported in neonates. This case describes a preterm infant, born at 31 weeks, who developed PED with thickened choroid at term-equivalent age, detected using handheld OCT. The PED emerged at 39 weeks postmenstrual age, coinciding with inhaled steroid treatment for respiratory distress, and resolved by 41 weeks after steroid discontinuation without structural damage. The temporal relationship suggests an association between steroid use and PED with choroidal changes. This case highlights the value of OCT in detecting retinal and choroidal abnormalities in preterm infants and underscores the potential impact of systemic conditions and medications on the choroid.
