Diffuse chronic retinal pigment epitheliopathy and exudative retinal detachment

Two patients with bilateral chronic retinal pigment epitheliopathy are presented. Both patients had large areas of pigment epithelial decompensation and small pigment epithelial detachments at the posterior pole. In the macula subretinal fluid was scanty, but the first patient developed an extensive bullous retinal detachment with shifting of subretinal fluid with changes in posture in both eyes, the second patient had similar detachment in one eye. The etiology of the pigment epithelial disorder remained unknown. No inflammatory cells were found in the vitreous specimen or subretinal fluid in the first patient. Treatment with peroral corticosteroids alone or in combination with azathioprine and cyclosporin A, as well as surgery for retinal detachment in one eye, proved unsuccessful. Argon laser coagulation of the decompensated areas in the macula resulted in resorption of subretinal fluid and reattachment of the exudative detachment.