1. Acute Retinal Pigment Epithelitis
Dr. Dipankar Das, MS
Dr. Rachana Jain, DO, DNB
Dr.Harsha Bhattacharjee, MS
Sri Sankaradeva Nethralaya, Guwahati,
Assam, INDIA

2. Ocular History
22 year old lady
2-2007: OD blurred vision

3. March 2007: First Presentation
VA: OD 20/20, OS 20/20
No AC, vitreous reaction
Fundus:
Resolved Multifocal choroiditis OD

4. March 2007: First Presentation
CBC, Chest X Ray, CT Scan Brain and orbit –Normal,VDRL-Non reactive, Mantoux test 9mm induration, FFA Resolving lesions
Kept under observation
Improvement

5. After 14 days March 2007 OS Blurred vision VA OD 20/20, OS 20/20
No reaction in AC & vitreous
Fundus OS Creamish subretinal lesion with few hyperpigmented dark grey areas surrounded by yellowish white halo.
FFA, hypoflourescence surrounded by hyperflourescence in active lesions

8. After 14 days March 2007 ERG- Normal EOG- Subnormal Left eye
CBC, Mantoux, VDRL, CX Ray - Normal
Observation

10. April 2007
VA 20/20 OD, 20/20 OS
Resolving lesion left eye

12. May 2007
OD: 20/20, OS: 20/20
Healed lesion OS

14. EOG (last follow-up)-OU WNL

15. Final Diagnosis Acute Retinal Pigment Epithelitis
Atypical clinical manifestation immitating
MEWDS
Acute Macular Neuroretinopathy
Acute posterior multifocal placoid pigment epitheliopathy
Central serous chorioretinopathy
Rubella retinitis
No treatment required

16. Problems Rare New Clinical Entity
Subtle fundus changes that can be missed, if not kept in mind.

17. Conclusion
Acute retinal pigment epithelitis or Krill’s disease is a rare, yet relatively new clinical entity (1972)
Characterised by Acute inflammation of the retinal pigment epithelium and manifested by transient and subtle alteration at the level of the RPE
Needs no treatment, remission and recurrences noted with good visual prognosis

18. Thank you