Acquired RPE Hyperplasia

Optomap (1), red separation (2) and green separation (3) images

Optomap imaging shows a darkly pigmented lesion with irregular borders and regions of chorioretinal atrophy in the superotemporal periphery of the left eye.

The fundus displays a tigroid appearance with visibility of the underlying choroidal vessels due to the presence of high myopia.

Spectralis OCT line scans through the area of RPE hyperplasia

OCT scans show marked retinal thinning, RPE irregularity and thickening. There are also regions of RPE attenuation associated with signal hypertransmission into the choroid.

Optomap (1), red separation (2) and green separation (3) images

Optomap imaging shows a flat region of retinal atrophy with central RPE hyperplasia at the superior vascular arcade of the right eye. Its borders are irregular but well dermarcated.

Fundus autofluorescence image

FAF imaging shows uniform dense hypo-autofluorescence with a surrounding halo of hyper-autofluorescence (suggestive of RPE dysfunction)

Spectralis OCT line scan through the lesion

OCT line scans shows RPE thickening, retinal atrophy and an absent ellipsoid zone throughout the lesion. There are also focal areas of RPE loss associated with choroidal hypertransmission.

Optomap and green separation images (left eye)

Widefield imaging shows RPE hyperplasia secondary to a chronic retinal detachment in the temporal and superior-temporal retina of the left eye.

Colour fundus photography and red-free image (left eye)

Fundus appearance shows an avoid area of hyper pigmentation superonasal to the optic nerve head with regions of internal pigment atrophy. There was also a smaller hyper pigmented ring superior to the optic nerve head. Red free viewing highlights bordering depigmentation around these areas.

Fundus autofluorescence image (FAF)

Autofluorescence shows discrete areas of intense hypofluorescence in the regions of hyper pigmentation as well as a more diffuse linear hyperfluorescent zone extending nasally adjacent to the hypofluorescence.

Spectralis OCT line scans (left eye)

OCT shows an area of intrachoroidal cavitation surrounded by RPE hyperplasia (appearing as a thickening of the RPE layer) and adjacent areas of overall retinal thinning with particular loss of the outer retinal layers. Hyper transmission of the OCT signal through the choroid can be seen where the RPE is absent.