Adult-onset foveomacular vitelliform dystrophy with retinal folds

Background: Adult-onset foveomacular vitelliform dystrophy is characterized by a solitary, oval. slightly elevated, yellowish subretinal lesion of the fovea. We examined a patient with adult-onset foveomacular vitelliform dys trophy with stellate retinal folds by optical coherence tomography and scan ning laser ophthalomoscopy. Case: A 58-year-old Japanese woman with a complaint of decreased vision in her right eye was diagnosed as having adult-onset foveomacular vitelliform dystrophy. Observations: Ophthalmoscopic examination revealed a yellowish lesion of on e-third disc diameter in size at the fovea in the right eye. Fluorescein an giography demonstrated an irregular block of choroidal fluorescence corresp onding to the yellowish lesion, which was surrounded by stellate retinal fo lds. Optical coherence tomography images showed a steep elevation of the re tinal pigment epithelium (RPE) as a focally protruded reflective band over an optically clear space. Scanning laser ophthalmoscopy provided morphologi c enhancement in the specifically affected layers of the macula. Using an a rgon green laser, band-shaped bright reflexes were seen in the right fovea. The helium-neon laser revealed a bright patch corresponding to the yellowi sh lesion over the fovea, which was surrounded by stellate retinal folds. T he diode laser revealed a bright patch corresponding to the yellowish lesio n. Conclusion: The stellate retinal folds of this patient were considered to b e caused by the steep elevation of the RPE with an extracellular accumulati on of the vitelliform deposits. Jpn J Ophthalmol 2001;45:533-537 (C) 2001 J apanese Ophthalmological Society.