Retinal pigment epithelium decompensation. I. Clinical features and natural course.

We studied 97 eyes (73 patients) that showed a sharp contrast between the grossly normal appearance of the posterior pole by funduscopy and the fluorescein angiography findings of multiple patches of retinal pigment epithelium (RPE) transmission defect in the early transit, associated with focal areas of RPE staining in the late transit. The staining was located primarily at the superior edge of the RPE defect (63 eyes). The average age of the patients was 52.2 years at the time of diagnosis, and the ratio of men to women was 3.5 to 1. Ocular histories were unremarkable, except for 27 eyes with documented central serous retinopathy. Thirty-two consecutive eyes have been followed for an average of 3.9 years, and 30 of those eyes have shown visual deterioration.