Stargardt's disease / fundus flavimaculatus

A patient with prominent yellow flecks and macular changes
The posterior pole contains yellow flecks with indistinct border (so called fish scale or pisciform lesions, 
the lesions are lipofuscin found within the RPE). There is retinal pigment epithelium atrophy in the fovea 
(so called bronze beaten appearance, there may be exposure of the choroidal blood vessels). The condition 
is an inherited bilateral disorders (autosomal recessive being the commonest and occasionally autosomal 

Other signs:

  • yellowish flecks are not needed for the diagnosis of Stargardt's disease. In the central type of

  • Stargardt's disease, the only lesion may be atrophic foveal lesions. Therefore, always include 
    Stargardt's disease in your differentiatial diagnosis in any young patients with bilateral macular 


1. What is the differential diagnosis of Stargardt's disease?

2. What is the typical presentatio of Stargardt's disease?

3. What is dark choroid and is it pathognomonic of  Stargardt's disease?

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Dark choroid in a patient with early Stargardt's disease.
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