[Diffuse retinal epitheliopathy and central serous chorioretinopathy]

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Imaging

Background:

• Diffuse retinal pigment epitheliopathy (D.R.P.E.) is a chronic condition characterized by multiple subretinal foci of leakage, retinal pigment epithelium alterations, and serous detachments.
• It shares similarities with central serous choroidopathy (C.S.C.) but presents distinct clinical and demographic features.

Observation:

• Follow-up examinations of 27 patients with D.R.P.E. over 37 months revealed chronic courses with common recurrences of subretinal leakage.
• Compared to C.S.C., D.R.P.E. patients were older (49 vs. 39 years), exhibited higher bilaterality (88%), and less frequent serous detachments (31%).
• D.R.P.E. lesions were often multiple, scattered, extra-macular, peripapillary, and associated with pigment epithelium depigmentation, frequently oriented inferiorly.

Findings:

• D.R.P.E. is associated with significant visual field defects (70.5%), dyschromatopsia (64%), and electroretinogram (E.O.G.) abnormalities (75%).
• While both D.R.P.E. and C.S.C. involve subretinal leakage and serous detachments, D.R.P.E. shows greater diversity in pigment epithelium lesions and functional impairment.
• Macular pigment involvement in D.R.P.E. correlates with a poor long-term visual prognosis.

Implications:

• Photocoagulation of leaking spots causing macular detachment may be beneficial in D.R.P.E., similar to its use in C.S.C.
• The long-term visual outcome in D.R.P.E. is critically dependent on the extent of pigmentary changes within the macula.
• Understanding the distinct features of D.R.P.E. is crucial for accurate diagnosis and management to preserve visual function.