The Retina Reference

Stargardt Disease - Progression

Please look at the photos of a normal retina for comparison. The images above come from a 58 year woman that has been seen over a course of 7+ years for Stargardt Disease in both eyes. This condition is a progressive, bilateral disease that causes decrease in central vision. It produces a beaten-bronze appearance around the fovea in advanced cases. This case was not advanced. Her best corrected vision at the initial visit was 20/40 in her right eye and 20/32 in her left. Fundus images of both eyes show tan flecks of the retinal pigment epithelium (black arrows). Accumulation of lipofuscin is seen in her fundus autofluorescence images taken in 2016 (red arrows, whiter areas). Areas of dead retinal pigment epithelial cells are dark (yellow arrows). Optical coherence tomography photos reveal damage to the retinal pigment epithelium and photoreceptor layers (compare the areas of intact retinal pigment epithelium at the green arrows to areas without these layers at the red arrows). Her visual acuity in 2017 had decreased to 20/200 in both eyes. There is currently no treatment for patients with Stargardt Disease, but they are advised not to take excessive vitamin A, which may accelerate the rate of visual decline.