Multifocal posterior pigment epitheliopathy in a patient with rheumatoid arthritis

A 46 year old male had noticed blurring of vision 4 years before in the right eye and 7 months before in the left. Pain in the shoulder and the ankle had developed 4 years before. When seen by us, both eyes showed subretinal exudates with macular atrophy. The left eye also showed bullous retinal detachment. He was diagnosed as bilateral multifocal posterior pigment epitheliopathy. The fundus lesions improved after laser photocoagulation. Few weeks later, the arthritis started to aggravate and to involve more joints. He was diagnosed as rheumatoid arthritis according to the criteria by the American Rheumatism Association. He did not show systemic hypertension, renal dysfunction. There was no history of systemic corticosteroid treatment.