Visual Quality in Acute Retinal Pigment Epitheliitis: A Case Report

Background and Clinical Significance: Acute retinal pigment epitheliitis is a retinal disorder considered as part of a larger group named idiopathic choroidopathies. Little gray round macular lesions at the retinal pigment epithelium can be found, which are self-limited, resolving within 6-12 weeks. It can decrease best corrected visual acuity (BCVA), but visual quality has not been studied yet. Case Presentation: A 17-year-old Caucasian boy who came to our ophthalmology department and presented with acute retinal pigment epitheliitis in his right eye (OD). BCVA under mesopic lighting was 0.18 logMAR in his OD and -0.18 in his OS. With a neutral density filter, it was 0.52 and 0.04, respectively. Contrast sensitivity was assessed with the CSV-1000E test, but OD outcomes were worse only in the case of mesopic lighting. Chromatic discrimination was assessed with the Farnsworth-Munsell 100 test and revealed marked impairment of both red-green and yellow-blue axes. No central scotoma was detected on a 10.2 visual field, nor was any halo perception detected with the Halometer test. Conclusions: BCVA under low illumination and color perception in the yellow-blue axis may be affected in patients with acute retinal pigment epitheliitis to a greater extent than previously described. Contrast sensitivity may also be altered, but to a lesser extent.