Retinitis pigmentosa unilateral: reporte de caso

Abstract

Objective: Clinical case report of a patient with suspicion of unilateral pigmentary retinopathy. Clinical case: 58-year-old woman presenting with progressive visual acuity (VA) loss of 6 years of evolution who referred a history of ischemic brain stroke that had occurred sometime before. Examination revealed: uncorrected VA: right eye (RE): 7/10, left eye (LE): 2/10; spectacle-corrected VA: RE: 10/10, LE: 5/10. Biomicroscopy: normal in both eyes. Funduscopy: RE: normal appearance, LE: vitreous floaters, mildly pale optic disc, decreased vessel diameter, reduced foveal brightness and osteoblast-shaped pigments in the four retinal quadrants. Electroretinogram (ERG): normal on the right side, abnormal morphology on the left side and significantly decreased retinal response amplitude on the left side. Additional tests and serology for infectious disease yielded negative results. Differential diagnosis with typical and other atypical forms of retinitis pigmentosa, as well as with other secondary pigmentary retinopathies, was made. Conclusion: Unilateral retinitis pigmentosa is rare and its diagnosis is based on the appearance of the eye fundus and on unilateral ERG abnormalities. The presence of infections, inflammatory and vascular causes should be ruled out. In spite of advances made in image acquisition and tests, this disease is still a challenge due to its heterogeneous manifestation.