Difficulties in differential diagnosis between the hereditary retinitis pigmentosa and “leopard skin” retinopathy

The aim of the study is to present the diagnostic difficulties in differentiating the hereditary form of retinitis pigmentosa (RP) from “leopard skin” retinopathy on the example of a case report of a 34-year-old woman. The patient presented typical features of hereditary RP in the examination of eye fundus and visual field testing combined with a history suggesting “leopard skin” retinopathy. RP is the most common retinal dystrophy characterized by gradual loss of photoreceptors, bone spicules pigment deposits in the middle periphery of the retina, narrowing of the retinal arteries, and pale optic disc. Clinical symptoms similar to those observed in hereditary forms of RP are also present in the so-called “leopard skin” retinopathy - acquired retinal disorder associated with the use of certain drugs, e.g. immunosuppressants, organ transplant, leukemia and other diseases. The mechanism of this disorder is still not fully understood but the influence of circulatory disturbances at the choroidal level are mainly suspected. Based on the case presented below, it can be said that distinguish between RP and leopard skin retinopathy can be difficult. Electroretinography and genetic tests are included in the differential diagnosis process.