Stargardt Disease - Pigment Flecks

The fundus autofluorescence (FAF) and optical coherence tomography images above were taken in a patient with Stargardt disease. The patient complained of blurry vision in both eyes for 2 weeks and a black spot in her left eye field of vision. Her visual acuity in her right eye was 20/20 and left 20/25. Her maculas showed subretinal pigment flecks and mottling bilaterally. In the FAF images, lipofuscin flecks appear hyper-reflective (yellow arrows). Atrophic pigment epithelial spots were hypo-reflective (red arrows). A loss of the RPE layer is seen in her optical coherence tomography (OCT) photos (blue arrows). Vitamins do not help, and large doses of vitamin A should not be taken.