Abstract

P 177

Homonymous focal macular pigmentepitheliopathy of unknown origin

Pegah Heidari, Rodrigo Barbieri, Stephan Schulze
Augenklinik, Standort Marburg, Universitätklinikum Gießen und Marburg, Marburg

Objective
A 33-year-old male patient complained a decrease of visual acuity (VA) on both eyes and a visual field defect in the inferior part of the left eye.
The patient reported a extence exposure of “super-LED” flashlight direct to both of his eyes a few days before. Furthermore the patient suffered from a viral infection since one week, which was diagnosed as hand, foot and mouth disease.
Methods
Visual acuity was decreased to 0.63 on the right eye and 0.4 on the left eye. The anterior segment and the pupillomotoric were without pathological findings. The posterior pole of both eyes showed a bright and edematous area in the superior part of the macula. A paracentral scotoma could be demonstrated by Goldmann perimetry.
Results
Tree days after treatment with prednisolon 100 mg, visual acuity increased to 1.0. At this time fluoresceinangiography disclosed a pigment epithelial defect at the superior part of the macula (OU). The blood tests showed increased levels of viral IgG-antibodies, but there was no sign of an acute infection. The perimetry presented a small relative paracentral scotoma in the central 30°.
Conclusions
In this case report the homonym location of the macular lesions is of great interest. This finding is not typical for a macular dystrophy, as generally, they would be located on the same side of each eye. One of the differential diagnosis is multifocal choroiditis. But also retinopathia solaris is a possible differential diagnosis, which would explain the locations of the pigment epithelial defects. A viral infection can be considered aswell, because of the high viral IgG-antibody levels (Adeno virus, Coxsackie virus, Ebstein-barr virus and Hepes simplex).

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