PMID- 28284786
OWN - NLM
STAT- MEDLINE
DCOM- 20170717
LR  - 20180518
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 124
IP  - 6
DP  - 2017 Jun
TI  - Serial Spectral-Domain Optical Coherence Tomography Findings in Acute Retinal 
      Pigment Epitheliitis and the Correlation to Visual Acuity.
PG  - 903-909
LID - S0161-6420(16)32025-5 [pii]
LID - 10.1016/j.ophtha.2017.01.043 [doi]
AB  - PURPOSE: To evaluate the features of acute retinal pigment epitheliitis (ARPE) at 
      onset and in the course of recovery by serial spectral-domain optical coherence 
      tomography (SD OCT) and the correlation to visual acuity (VA). DESIGN: 
      Retrospective cohort study. PARTICIPANTS: Consecutive patients with ARPE. 
      METHODS: A review of medical records was performed. MAIN OUTCOME MEASURES: 
      Integrity of SD OCT retinal bands at onset and in the course of disease, time 
      required to achieve each retinal band restoration, corresponding VA change, and 
      final VA. RESULTS: Four patients were included. Initial SD OCT showed a 
      dome-shaped hyper-reflective lesion at the photoreceptor outer segment layer 
      disrupting the ellipsoid zone (EZ) and interdigitation zone (IZ) (100%). In the 
      early phase, there was also upward displacement of the external limiting membrane 
      (ELM) and mild transient thickening of the retinal pigment epithelium 
      (RPE)/Bruch's complex (Bc). Acute retinal pigment epitheliitis resolved in a 
      sequence of (1) a decrease in height of SD OCT hyper-reflective lesion and the 
      upwardly displaced ELM returning to its normal position with irregularity; (2) 
      complete disappearance of the hyper-reflective lesion; (3) restoration of ELM; 
      (4) restoration of EZ; and (5) restoration of IZ. The average time to restore 
      ELM, EZ, and IZ was 4.3+/-5.2, 7.3+/-7.2, and 12.5+/-12.4 weeks, respectively, and the 
      corresponding logarithm of the minimum angles of resolution (logMAR) VAs were 
      0.24+/-0.23, 0.09+/-0.07, and 0.05+/-0.06, respectively. Visual acuity improved when IZ 
      was restored. CONCLUSIONS: Early SD OCT revealed an inflammatory lesion in the 
      photoreceptor outer segment layer displacing ELM. The RPE was involved only 
      mildly and transiently. Recovery occurred in a sequence of ELM, EZ, and IZ 
      restoration, and VA improved when the IZ was restored. These features suggested 
      that the IZ (i.e., the contact between photoreceptors and RPE) is the primary 
      site of inflammation in ARPE.
CI  - Copyright (c) 2017 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Iu, Lawrence P L
AU  - Iu LPL
AD  - Department of Ophthalmology, The University of Hong Kong, Grantham Hospital, Hong 
      Kong.
FAU - Lee, Rachel
AU  - Lee R
AD  - Stanford University School of Medicine, Stanford, California.
FAU - Fan, Michelle C Y
AU  - Fan MCY
AD  - Department of Ophthalmology, The University of Hong Kong, Grantham Hospital, Hong 
      Kong.
FAU - Lam, Wai-Ching
AU  - Lam WC
AD  - Department of Ophthalmology, The University of Hong Kong, Grantham Hospital, Hong 
      Kong.
FAU - Chang, Robert T
AU  - Chang RT
AD  - Stanford University School of Medicine, Stanford, California.
FAU - Wong, Ian Y H
AU  - Wong IYH
AD  - Department of Ophthalmology, The University of Hong Kong, Grantham Hospital, Hong 
      Kong. Electronic address: ianyhwong@gmail.com.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170308
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Acute Disease
MH  - Administration, Oral
MH  - Adolescent
MH  - Adult
MH  - Cohort Studies
MH  - Female
MH  - Glucocorticoids/therapeutic use
MH  - Humans
MH  - Male
MH  - Retinal Pigment Epithelium/drug effects/*pathology
MH  - Retinitis/*diagnosis/drug therapy/physiopathology
MH  - Retrospective Studies
MH  - Statistics as Topic
MH  - *Tomography, Optical Coherence
MH  - Visual Acuity/*physiology
MH  - Young Adult
EDAT- 2017/03/13 06:00
MHDA- 2017/07/18 06:00
CRDT- 2017/03/13 06:00
PHST- 2016/11/16 00:00 [received]
PHST- 2017/01/27 00:00 [revised]
PHST- 2017/01/27 00:00 [accepted]
PHST- 2017/03/13 06:00 [pubmed]
PHST- 2017/07/18 06:00 [medline]
PHST- 2017/03/13 06:00 [entrez]
AID - S0161-6420(16)32025-5 [pii]
AID - 10.1016/j.ophtha.2017.01.043 [doi]
PST - ppublish
SO  - Ophthalmology. 2017 Jun;124(6):903-909. doi: 10.1016/j.ophtha.2017.01.043. Epub 
      2017 Mar 8.