Clinicopathologic correlation of the multiple recurrent serosanguineous retinal pigment epithelial detachments syndrome

Matthew W. MacCumber, Kourosh Dastgheib, Neil M. Bressler, Chi Chao Chan, Michael Harris, Stuart Fine, W. Richard Green

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Ocular clinicopathologic correlation in a patient with bilateral multiple recurrent hemorrhagic detachments of the sensory retina and retinal pigment epithelium (RPE), which eventually led to rubeosis and loss of useful vision in one eye, is described. The clinical appearance was most consistent with multiple recurrent serosanguineous RPE detachments syndrome (which may be similar to posterior uveal bleeding, or PUB, syndrome). Methods: Light microscopic examination of 450 serial sections through a 3.7-mm area including the macula, optic nerve head, and superior and inferior peripapillary region of the eye that underwent diagnostic enucleation was performed. One fresh cap was used for immunohistochemical staining. Tissue from the posterior aspect of the other cap was prepared for electron microscopy. Results: Microscopic examination disclosed extensive fibrovascular proliferation in the subretinal space and within Bruch’s membrane, and the presence of at least 23 choroidal blood vessels that traversed defects in Bruch’s membrane. Immunohistochemical studies of inflammatory infiltrates within the choroid and fibrovascular tissue demonstrated both a B- and T-cell response. Conclusion: In this case, recurrent serosanguineous detachments of the sensory retina and RPE were secondary to choroidal neovascularization with extensive fibrovascular proliferation in the subretinal space and within Bruch’s membrane. Marked lymphocytic infiltration was present throughout the choroid and the fibrovascular tissue. Clinical improvement in the fellow eye after immunosuppressive therapy suggested that an immunologic component might be a causative factor, although the waxing and waning course in this condition precludes any definitive evaluation for its use in multiple recurrent serosanguineous RPE detachments syndrome.

Original languageEnglish (US)
Pages (from-to)143-152
Number of pages10
JournalRetina
Volume14
Issue number2
DOIs
StatePublished - Jan 1 1994

Keywords

  • Choroidal neovascularization
  • Clinicopathologic correlation
  • Multiple recurrent serosanguinous retinal pigment epithelial detachments
  • Subretinal fibrosis
  • Subretinal hemorrhage
  • Subretinal pigment epithelial fibrosis
  • Subretinal pigment epithelial hemorrhage

ASJC Scopus subject areas

  • Ophthalmology

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