A 44-year-old presents with poor night-time vision. Why?

Tip #234


There is some fluid noted in the inner nuclear layer and at the junction of the outer plexiform/outer nuclear junction. In addition, there is significant thinning of the outer nuclear layer and loss of the external limiting membrane and ellipsoid zone. The patient was noted to have reduction in autofluorescence in the periphery and hyper autofluorescence in the macular area (video).

The patient was treated for Retinitis Pigmentosa.

In this tip's accompanying 12 min. video, we'll review:

  • The differential diagnosis of outer retinal thinning
  • FAF features of RP
  • Causes of pigmentary retinopathy
Tip #234 Analysis


In a patient with outer retinal thinning on OCT, retinitis pigmentosa should be considered, especially when the thinning is in the peri-macular area.

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