The Retina Reference

Macular Pattern Dystrophy - Long Term Case

This patient complained of difficulty reading fine print in 2005. Her visual acuity was 20/20 in the right eye and 20/32 in the left. She had a pigmented, atrophic scar temporal to the fovea with macular lipofuscin flecks in the right eye. Her left eye also showed flecks and lesser signs of retinal pigment atrophy. These are typical findings associated with pattern dystrophy of the retinal pigment epithelium (RPE), a bilateral genetic macular disease. In 2017, her visual acuity was 20/80 in the right eye and 20/32 in the left. Fundus autofluorescence imaging showed lipofuscin deposits in the mid periphery (yellow arrows) and RPE atrophy in the macula (blue arrows) in both eyes. Loss of the RPE layer is visible in her optical coherence tomography (OCT) scans (red arrows). The differential diagnosis includes age-related macular degeneration and Stargardt disease. Low vision aids are recommended when the visual handicap progresses enough to bother the patient. There is currently no treatment for this condition.