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Adult-onset vitelliform macular dystrophy

One of the most common pattern dystrophies similar to best occurs in adulthood, as it appears as oval or yellowish macular material, originated from the debris of photoreceptors, or the RPE phagocytosis failure.

Adult-onset vitelliform macular dystrophy
Fundus image showing Adult-onset vitelliform macular dystrophy 


On OCT, it appears as subretinal vitelliform material accumulation but above the RPE with intact ellipsoid zone and thus explains good visual acuity without an increase in retinal thickness.

OCT cross-section showing Adult-onset vitelliform macular dystrophy
OCT cross-section showing Adult-onset vitelliform macular dystrophy


Fluorescein angiography typically shows hypo-fluorescence at the area of vitelliform accumulation surrounded with hyper-fluorescence increases intensity in late phases; however, it may show liner, patchy, or ring-like, which is inconsistent with visual acuity.

Adult-onset vitelliform macular dystrophy itself does not warrant any treatment; however, a regular follow up to monitor any progression to choroidal neovascularization.

How would you approach and manage this case?!


Please check Clinical guidelines for Pattern dystrophy

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