Maurice F. Rabb » Pigment Epithelial Lesions

29 year old white woman who was referred by the University of Florida Renal Clinic to our Eye Clinic for a routine examination. She has a known partial lipodystrophy, membrano-proliferative glomerulonephritis, and a hypocomplementemia. She had no ocular or visual complaints. Her acuity was 20/20 OU with no correction. Anterior segments were normal OU.

The interesting findings were limited to her fundi which revealed discrete pale pigment epithelial lesions which looked like a small bubbles under the retina, especially when the illuminating light reached the edge of the lesions. They were of much lower contrast and more translucent than drusen. Moreover, their distribution was not characteristic of drusen, being arranged in a ring peripapillarly and in clumps temporal to the fovea in both eyes. The rest of the fundus appeared normal bilaterally. Fluorescein angiogram revealed staining of these lesions with no leakage of dye, as simply window defects in the pigment epithelium. ERG was normal; the EOG was slightly depressed (to 155 OU).

The family history and ocular examination of the patient's children were negative for any eye diseases. They were examined and no similar spots were seen.