Pattern Dystrophy - Progression in One Eye Over The Other

The images above belong to a 50-year-old female who was seen for complaints of blurred vision in her right eye. Her visual acuity was 20/30 in the right eye and 20/20 in the left. Fundus examination noted a vitelliform lesion (white arrow) and pigment clumps in her right eye. Although indistinct in the images, her left eye had mild retinal pigment epithelium (RPE) mottling. These characteristics are typical of macular pattern dystrophy of the RPE. In this case, there were more lipofuscin deposits under her right macula (yellow arrow), which was the cause of her visual complaint. This is however, a bilateral disease and therefore it is common for patients to notice visual disturbances in one eye before seeing changes in the fellow eye. The disease is generally less severe than age-related macular degeneration and is usually compatible with reading and driving vision throughout life. It is associated uncommonly with choroidal neovascularization.