PMC5070481_01
Right (a-c) and left (d-f) eye. Color photographs of the fundus (a, d) , early- (b, e) and late-phase (c, f) fluorescein angiograms
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F1
Fundoscopy revealed pigment clumpings surrounded by a yellow halo in the macular region of the right eye, and slightly elevated yellowish round PEDs in the left eye (Figure 1 a, d (Fig. 1)). Fluorescein angiography performed at the baseline demonstrated multifocal, irregularly distributed fluorescence-blocking lesions surrounded by a halo of window defect in the right eye (Figure 1 b, c (Fig. 1)), as well as three foci of dye pooling without active leakage in the left eye (Figure 1 e, f (Fig. 1)).
Serial horizontal OCT scans of the left eye through the RPE detachments illustrating their natural history. Three dome-shaped RPE detachments were found, 1,670 microm from the fovea at 9 o'clock (left panels), 3,200 microm from the fovea at 10:30 o'clock (middle panel), and 750 microm from the fovea at 2 o'clock (right panel). The images were taken at the baseline, as well as after one, two, three, four and seven years of follow-up (from top to bottom, respectively). All the PEDs had round basis with diameters ranging from 498 to 593 microm (left panel), 423 to 486 microm (middle panel) and 1,144 to 1,225 microm (right panel). The height of the elevations varied, reflecting their flattening and complete resolution, and ranged from minimal to 63 microm (left panel), minimal to 135 microm (middle panel) and 106 to 235 microm (right panel). The presence of the detachments was not associated with fluid accumulation between RPE and neurosensory retina. The RPE layer within the detachment was continuous and showed no defects. The thickness, structure and foveal contour of the overlying retina were normal.
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F2
OCT raster scans (Figure 2 (Fig. 2)). OCT enabled us to detect the PEDs, conduct a differential diagnosis and monitor the PEDs.