Salt-and-Pepper Retinopathy of Rubella

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     A 39-year-old woman presented at a clinic for a second opinion regarding a diagnosis of age-related macular degeneration, which had been noted on routine ophthalmologic examination. She reported having no visual problems. Her medical history was notable for congenital hearing loss associated with her mother's having contracted rubella during her pregnancy. The visual acuity was 20/20 in both eyes. Findings on slit-lamp examination and intraocular pressure were normal. Funduscopic examination revealed granular, pigmentary mottling in the macula and periphery, with punctuate hypopigmentation (arrowheads) and hyperpigmentation (arrows) consistent with the "salt-and-pepper" retinopathy of rubella. The findings on cardiac examination were normal. The classic triad of congenital rubella includes ocular abnormalities, heart disease, and deafness, but myriad other signs have been reported. Congenital rubella produces a classic salt-and-pepper pigmentation of the fundus, as seen in this patient. The nonprogressive retinopathy is generally benign and does not interfere with vision unless choroidal neovascularization develops in the macula. At follow-up four months later, the patient continued to be asymptomatic and no changes were noted on examination.

    Rahul N. Khurana, M.D.

    Srinivas R. Sadda, M.D.

    Doheny Eye Institute

    Los Angeles, CA 90033

    http://www.100md.com/html/DirDu/2007/01/01/33/27/78.htm