This healthy 31YO presented with sudden vision loss in her right eye.
The fundus image shows a single yellow subfoveal lesion, which appears as a hyperreflective pillar extending into the outer nuclear layer on OCT.
The differential includes solar retinopathy, laser pointer maculopathy, whiplash maculopathy, acute retinal pigment epitheliitis (RPEitis), and central serous retinopathy. There was no history of sungazing or trauma.
She returned 6 weeks later with resolved symptoms and 20/20 vision. We think this was a case of acute RPEitis (Krill’s Disease).
Learning Points:
Acute RPEitis is a self-limited inflammatory disease that affects young adults. Initially felt to be an inflammation of the RPE, it is now thought to be an idiopathic inflammation of the photoreceptors. It presents with one or more small yellow-white macular lesions.
With resolution, the macular appearance can normalize, or patients can be left with a small outer segment defect similar to solar retinopathy.
