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| CASE REPORT |
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| Year : 1997 | Volume
: 45
| Issue : 2 | Page : 115 |
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Solitary hypopigmented nevus of the retinal pigment epithelium in the macula
NS Bhatt, M Shah
Bombay Hospital and Taparia Institute of Ophthalmology, Mumbai
Correspondence Address:
N S Bhatt
Bombay Hospital and Taparia Institute of Ophthalmology, Mumbai
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 9475030 
How to cite this article:
Bhatt N S, Shah M. Solitary hypopigmented nevus of the retinal pigment epithelium in the macula. Indian J Ophthalmol 1997;45:115 |
We are presenting a rare benign condition of retinal pigment epithelium (RPE) called solitary hypopigmented nevus of RPE.[1] This condition has been described sparingly, and to our knowledge this is the first reported case in India.
| Case summary | |  |
A 21 year old male came to us for a routine eye examination without any specific complaints. He had a visual acuity of 6/6, N6 in each eye. The right eye was normal. Anterior segment of the left eye was unremarkable, fundus examination showed a solitary sharply circumscribed, oval, orangish white, placoid lesion with a wedge shaped tail at level of RPE in the macula. There were ill-defined dense white spots within the lesion ([Figure:1a] & [Figure:1b]). No abnormality of visual field was determined on Amsler's grid. There was no positive family history or any systemic disease.
| Discussion | | |
Nevi of the RPE differ in the amount of pigmentation and accordingly can be described as melanotic (dark-grey or black), albinotic (white) or hypopigmented (orange).[2],[3] The case above illustrates a typical orange coloured hypopigmented nevus of RPE. The nature of the white spot within the nevus is unknown but may be abnormal melanin or one of its precursors. The oval shape and tail like protrusion was similar to that seen in patients with multiple solitary RPE nevi associated with Gardner's syndrome.[4]
Histopathology of RPE nevi has been described by Schlemitzauer and Greene.[5] Hypopigmented RPE nevi are composed of a layer of intact RPE cells containing little or no melanin. The retina overlying hypopigmented RPE nevi and the choroid and Bruch's membrane underlying it are usually normal. Hence in our case the visual acuity and Amsler's grid were normal.
In conclusion we have presented a rare interesting benign condition of RPE which has a characteristic appearance and should not be confused with other macular lesion.
| References | | |
| 1. | Roseman RL, Gass JDM. Solitary hypopigmented nevus of the retinal pigment epithelium in the macula. Arch Ophthalmol. 110:1358-1359, 1992  |
| 2. | Gas JDM. Focal Congenital anomalies of the retinal pigment epithelium. Eye:3:1-18, 1989. |
| 3. | Gass JDM. Differential Diagnosis of Intraocular Tumours: A Stereoscopic Presentation. 1974, St. Loius, Mosby-Year Book pp 221-246. |
| 4. | Blair NP, Trempe CL. Hypertrophy of the retinal pigment epithelium associated with Gardener's syndrome. Am J Ophthalmol. 90:661-667, 1980 |
| 5. | Schlernitzauer DA, Green WR. Peripheral retinal albinotic spots. Am J Ophthalmol. 72:729-732, 1971 |
[Figure - 1], [Figure - 2]
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