Pattern Dystrophy At a Young Age

These are photographs from a 21-year-old female who presented with complaints that straight lines appeared wavy. Her visual acuity was 20/40 in the right eye and 20/30 in the left. On her fundus exam, there were tan flecks in the macula of both eyes (yellow arrows on fundus photos). These flecks are associated with pattern dystrophy of the retinal pigment epithelium (RPE). Optical coherence tomography (OCT) scans show subretinal deposits under the macula that had not changed within a year (red arrows). This is not macular degeneration; the prognosis of pattern dystrophy is much better. Young patients with this disease are typically still able to read and drive as they age. The incidence of choroidal neovascularization is much lower in pattern dystrophy than in age related macular degeneration.