Two patients with bilateral chronic retinal pigment epitheliopathy are
presented. Both patients had large areas of pigment epithelial decomp
ensation and small pigment epithelial detachments at the posterior pol
e. In the macula subretinal fluid was scanty, but the first patient de
veloped an extensive bullous retinal detachment with shifting of subre
tinal fluid with changes in posture in both eyes, the second patient h
ad similar detachment in one eye. The etiology of the pigment epitheli
al disorder remained unknown. No inflammatory cells were found in the
vitreous specimen or subretinal fluid in the first patient. Treatment
with peroral corticosteroids alone or in combination with azathioprine
and cyclosporin A, as well as surgery for retinal detachment in one e
ye, proved unsuccessful. Argon laser coagulation of the decompensated
areas in the macula resulted in resorption of subretinal fluid and rea
ttachment of the exudative detachment.