Clinical Case of Retinal Pigment Epithelium Hyperplasia

Objective. To present a clinical case of retinal pigment epithelium hyperplasia (RPEH) in a patient with a history of familial adenomatous polyposis (FAP) of the colon.

Patient S., 75 yo, came to the clinic for a routine examination. No complaints regarding the organ of vision. OU: Vis=1.0 without correction; IOP is normal, perimetry, ultrasound examination of the eyeball are normal; initial opacities are present in the lens. Fundus examination: OU – the optic nerve head (ONH) is pale pink, the borders are clear, the macular area is normal, the vessels are unchanged. According to optical coherence tomography (OCT), no pathology of the vitreoretinal interface was detected in both eyes. OD – a hyperpigmented flat rounded formation measuring 2.0 optic disc diameters is visualized paramacularly in the superior temporal sector. The layers corresponding to the structural elements of the photoreceptors are blurred and locally destroyed above the described area. The inner layers of the neuroepithelium are somewhat deformed. The choriocapillary layer is thinned. No signs of prominence into the vitreous body were detected. The patient is registered with an oncologist with a diagnosis of familial adenomatous polyposis. Family history is burdened – the grandfather had colorectal carcinoma. Discussion. RPEH does not have a clinical picture and is often an accidental finding of an ophthalmologist.

Conclusions. This pathology is an early marker of familial adenomatous polyposis and requires careful differential diagnosis with other retinal diseases. Patients with RPEH require dynamic ophthalmological monitoring, since areas of epithelial hyperplasia may undergo pathological changes.

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