The cause of acute pigment epithelitis is unknown, possibly due to viral infection of the pigment epithelium, and it may also be seen in certain systemic diseases. ERG is normal, while EOG may show abnormalities. It predominantly affects young and middle-aged adults, occurring in one or both eyes simultaneously. The condition typically resolves on its own within 1 to 3 months, with a favorable prognosis.

bubble_chart Clinical Manifestations

1. Subjective symptoms: The onset is sudden, with a rapid decline in vision, blurred and dim vision, and micropsia, but vision can return to normal after recovery. Visual field examination reveals a relative central scotoma.

2. Fundus manifestations: Clustered lesions can be observed in the posterior pole, appearing as round gray-black dots about 1/4 PD in size, arranged in grape-like clusters. Sometimes, they are accompanied by a serous flat detachment of the retinal neuroepithelial layer. There is a yellowish-white ring with pigment loss around the lesions, which may leave small pigment spots or no trace after recovery. In the stage of regression, the gray dots turn black or fade and become indistinct, while the pale ring disappears.

3. Fundus fluorescein angiography: Grape-like clusters of fluorescent spots can be seen in the macular area, along with ring-shaped lesions that appear dark in the center (blocking fluorescence) and bright on the outside (transmitting fluorescence). Occasionally, a small amount of fluorescein leakage is observed. {|102|}

bubble_chart Diagnosis

1. It is more common in young and middle-aged males, with an acute onset, often suddenly affecting one eye, or both eyes successively, and has a self-limiting tendency. Repeated recurrences may lead to permanent visual impairment.

3. The typical fundus sign is dark gray spots around the macula surrounded by a faint pigment ring, often clustered like grapes. Fluorescein angiography reveals a fluorescent phenomenon with a dark center and bright periphery.

bubble_chart Treatment Measures

1. Extensive use of antiviral drugs.

2. Oral broad-spectrum antibiotics, vitamin B complex, and vitamin C.

3. High doses of vasodilators and energy mixtures.

4. Chinese medicinals: clearing heat and removing toxin agents. {|103|}