|Title||A CASE REPORT OF PIGMENTED PARAVENOUS RETINOCHOROIDAL ATROPHY (PPRA)|
|Author, Co-Author||Michelle Chan, Anne Spies|
|Abstract|| BACKGROUND: Pigmented Paravenous Retinochoroidal Atrophy (PPRA) is a diagnosis of exclusion that is based primarily on clinical findings. In the few reported cases, dense retinal pigment found exclusively next to retinal vessels are the sole ocular findings in an otherwise white and quiet eye. The etiology is probable past ocular inflammation that involved vasculitis. Some conditions that may be considered in the list of differential diagnosis should include systemic lupus erythematous, Bechet's, syphilis and frosted branch angiitis. It has been suggested in literature that PPRA may be part of a continuum of retinal conditions with viral-based etiologies.
CASE REPORT(S): A 36 year old hispanic woman presented to the Primary Eye Care service for a comprehensive exam with a chief complaint of longstanding decreased vision in both eyes. She reported an episode 15 years ago when she experienced an acute painless loss of vision in both eyes that lasted several hours. Her vision was subsequently recovered. She had never worn any spectacle correction. Her past medical, family and social history were unremarkable. Her best corrected visual acuity were 20/30 OD and 20/40 OS. All entrance tests and slit-lamp evaluation were unremarkable. Refraction showed a moderate amount of astigmatism. Dilated fundus exam revealed dense clumps of hyperpigmentation along both the upper and lower arcades of both eyes. Vitreous, optic nerves, macula and periphery were unremarkable. Further ancillary tests (fundus photos, Humphrey visual field, electroretinography, ocular coherence tomography) revealed no evidence supporting progressive retinal degeneration.
CONCLUSIONS: PPRA is a diagnosis of exclusion and should only be considered when there is no signs of active ocular inflammation or progressive vision loss. Thorough documentation and patient education should be part of the management and each subsequent follow-up. Any and all signs of inflammation should be adequately managed with the appropriate work-up and following treatment.
|Affiliation of Co-Authors||Illinois College of Optometry|